Talk:Aspirin-exacerbated respiratory disease

Paracetamol is not an NSAID, as may be understood from the wording "though paracetamol is generally considered safe" — Preceding unsigned comment added by 88.90.68.85 (talk) 15:32, 21 September 2011 (UTC)

The pathogenesis section is extremely confusing. In particular, the way the sentence describing differential PGE modulation I found difficult to understand. — Preceding unsigned comment added by 99.98.209.88 (talk) 14:09, 22 January 2013 (UTC)

Has anybody else encountered this condition with the additional symptom of severe acute pain around diaphragm & back (possibly associated with gallbladder/spleen) and, later, likely autoimmune haemolytic anaemia? — Preceding unsigned comment added by 95.151.241.169 (talk) 19:52, 25 September 2013 (UTC)

Also, interested in finding out more about the efficacy of aspirin desensitization for this condition. Does it reduce sensitivity to other allergens, such as ibuprofen & certain tree pollens (salicylate perhaps)? Does it really prevent or delay nasal polyps returning? Any dangers (when supervised by a GP)? — Preceding unsigned comment added by 95.151.241.169 (talk) 20:13, 25 September 2013 (UTC)

Allergy or intolerance

Is this an allergic reaction or an intolerance? Jim Derby (talk) 13:37, 5 March 2014 (UTC)

Neither, exactly. It is not considered an autoimmune disorder, but it is considered a chronic immune dysregulation. Andyleigh12 (talk) 14:29, 31 July 2018 (UTC)

Page Title

Is there a reason that the title of this page is Aspirin Induced Asthma as opposed to AERD (Aspirin Exacerbated Respiratory Disease) or NERD (NSAID Exacerbated Respiratory Disease)? For clarification, AERD and NERD refer to the same disorder - NERD is not used in English speaking countries due to the unfortunate acronym. Either way, "Aspirin Induced Asthma" is an outdated name for this disorder. It is referred to as AERD or NERD in all modern research. "Aspirin Induced Asthma" was moved away from because it does not adequately describe the disease, which involves more than asthma and involves all NSAIDs - not only aspirin. I would propose that the name of this page be changed to Aspirin Exacerbated Respiratory Disease since that is the most widely used name and the name used in the vast majority of modern research. Andyleigh12 (talk) 14:41, 31 July 2018 (UTC)

Incorrect Reference

"NSAIDs that are highly selective in blocking COX-2 and do not block its closely related paralog, COX-1, such as the COX-2 inhibitors celecoxib and rofecoxib, also are regarded as safe.[10]" The reference quoted to support this does not mention aspirin at all.

10.

TiredOfLondon (talk) 13:44, 24 November 2018 (UTC)

GA Review

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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This review is transcluded from Talk:Aspirin-exacerbated respiratory disease/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Etriusus (talk · contribs) 21:06, 27 February 2023 (UTC)

GA review (see here for what the criteria are, and here for what they are not)

@Lyall0:, I'll begin this review. I can see you've been inactive for the last month so I will give you an opportunity to respond before we get too far into this. 🏵️Etrius ( Us) 21:06, 27 February 2023 (UTC)

Thanks @Etriusus. I'm around, so I'll try to be responsive if anything comes up. Lyall0 (talk) 22:01, 27 February 2023 (UTC)

@Lyall0:, here're my first round of suggestions. 🏵️Etrius ( Us) 21:40, 1 March 2023 (UTC)

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Sourcing

• Strongly recommend running IAbot to archive sources, this isn't required but a friendly recommendation.
• It is also not required to have links in the sourcing, but this would be appreciated
• I have no immediate concerns about source reliability

Copy-vios

• Earwig caught 'DMRT3 could be potentially involved in nasal polyp development in AERD patients. Furthermore, several genes are downregulated, hinting at the dedifferentiation phenomenon in AERD polyps.'
• Random spot-checks turn up a few things I mention later on.

Images

• Image rights are in order, love the alt text
• For 'File:Arachidonic Acid Cascade Simplified.svg' and 'File:AERD Innate Immune Cells.svg', can you reiterate the sourcing in the caption.

Likewise, it would nice to mention on the File data itself that these images are adapted from other sources

Prose

Lead

• please read MOS:LEAD. The lead is way too short for the purposes of this article. Realistically, 2 solid paragraphs should be enough. The current amount isn't nearly enough
• Normally, synonyms are put in the first sentence. See Decompression sickness or most other medical GAs for further direction

There is an entire section dedicated to synonyms but there are sources missing. Additionally, it is preferable to stick to one style when listing synonyms. Currently the synonyms are listed in the infobox, intro, and body of the article, but are inconsistently listed. The excerpt about common names It is also commonly called NSAID-exacerbated respiratory disease (NERD/N-ERD), and historically aspirin-induced asthma and Samter's Triad. implies a naming history, which should just be merged with the history section rather than being its own bulleted section. Also, WP:BULLET, but I think the point is made.

• Reviewing footnote 1, it says "Previously used synonyms", implying that these names are defunct. This isn't reflected in the Wikipedia article, which implies these terms are still common synonyms.
• What is the purpose of FN 2 in the lead? This information isn't controversial and is cited elsewhere. I get that WP:CITELEAD isn't ironclad so I won't hold you to removing it.
• "common true" is this medical terminology? Saying "...rather than an allergic reaction...." would be better wording

Signs and symptoms

• general population the source says "general population in the USA", which needs to be clarified. The first half of these sentence also boarders on close paraphrasing
• Per footnote 10 considerably less common in parts of Asia should be mentioned.
• AERD patients may not have any allergies, though allergies are significantly more common in AERD patients than the general population not finding this in the source, perhaps you'll have better luck
• Reactions to NSAIDs range in severity and expression. Onset is usually... check the sourcing on this paragraph, I'm finding multiple claims not backed by the source

Cause

• The separation of information between Pathophysiology and cause sections seems arbitrary. The Pathophysiology section should be largely about the clinical biochemistry, while the causes section should be focused on the theories of a causal mechanism. These two sections appear to largely tread the same ground. I would recommend merging them into a single "Causes and Pathophysiology".

Pathophysiology

• "highly complex negative cycle", do you mean Negative feedback? 'Highly complex' should be cut.

The more I read the less I am convinced this is a classic negative feedback loop and neither source give much to make this conclusion.

• Overall this section is well written, if a bit on the technical side. It's a slog to fact check so I may find more stuff as time goes on.

Diagnosis

• See WP:BULLET, don't need a bulleted list
• Patients are considered candidates for an AERD diagnosis if they meet the following three points: Source missing, I assume it is FN 3?
• Further, if a patient meets two or more of the following criteria, then an AERD diagnosis is strongly considered and above. Some close paraphrasing through these bulleted points. I suspect that converting this to prose will solve the issue.
• FN 3, the paragraph that starts with During oral aspirin challenge test... gives more detail on physiological reactions
• FN 20 states "Underdiagnosis of aspirin sensitivity may be due to the lack of routine aspirin challenge testing of asthmatic patients who do not report a positive history of aspirin sensitivity.", which would be important to add

Management

• much effort goes into the prevention awkward wording
• "aspirin desensitization and therapy" or do you mean 'aspirin desensitization therapy'
• 'a range of biologic medicines' WP:WEASEL, be more direct
• Each treatment has benefits and drawbacks, so no one option can be recommended for all patients. reword
• Despite optimal medical management... Not directly supported in the source

I assume that this line "This type of asthma is not easy to treat. Half of the patients in the present study, in addition to inhaled steroids, required chronic oral corticosteroid therapy, a quarter received emergency intravenous corticosteroids treatment during the year preceding registration in the database." is what is being adapted. I don't see anywhere that states these patient were in optimal treatments and this info largely retreads previous ground.

• most beneficial depending on outcome measured reword
• 'rescue surgery' That comes out of nowhere, please move this subsection to below the surgery subsection
• so the significantly higher aspirin doses used for maintenance therapy are of some concern reword and clarify what this means, what concern specifically?
• This is borne out in studies.. This sentence is hard to follow
• highest certainty and magnitude of improvement effect reword
• not qualify under stricter prescription guidelines confusion wording. Is it that the patient's don't qualify for these treatments?
• Among biologics and aspirin desensitization and therapy What therapy specifically? Too many contractions
• 'large survey', specify
• Given that dysregulation... citation missing
• For example, a prospective randomized trial... it really isn't wikipedia's place to summarize methods for a study, this paragraph gets too involved with confounding variables also.
• 'experts on the disease' who?

Alternate and related names

• Lots of sources missing

History

• 'by Samter' Max Samter

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Comment: Do you have any previous Wikipedia experience? It's rare that new users send pages to GA, 'specially with so few edits overall. This isn't an indictment on you, I am just curious. If I've labeled something as option, it is still an improvement but is not required for the purposes of this review. I've made some copy-edits of my own, please review them when you can. Placing on hold till 03/08, please ping me if you have any questions/concerns. 🏵️Etrius ( Us) 21:40, 1 March 2023 (UTC)

@Lyall0, Just giving you a customary ping since you haven't been active since my last ping (02/27), and haven't responded to the edits yet. It is customary that GA reviews are open for only a week, and can be extended based upon reviewer's discretion, but it is expected that the nominator be timely in their responses. I understand if IRL obligations may keep you away from Wikipedia, so just let me know if you need any accommodation. I'll probably ping you again on Monday if there is no response, but the article will enter into an automatic fail if the review remains inactive. As always, if you have any concerns or questions feel free to @ me. 🏵️Etrius ( Us) 17:23, 3 March 2023 (UTC)

Thanks for all the feedback. No I don't have a ton of Wikipedia experience apart from being a heavy and long time reader (naturally). I wasn't planning on submitting the article for GA review originally, but the reviewer who bumped it from C-class to B-class suggested I give it a shot. If you think the article is a long way from GA please let me know. I'm happy to put in some work to improve the article but not trying to waste anyone's time here if the whole thing is ill advised :)

And sorry for the slow response, I've been traveling this week and will be for a few more days. I'll try to start addressing some of the feedback today or tomorrow but I'm not sure how much I'll be able to get to right now. Lyall0 (talk) 18:27, 5 March 2023 (UTC)

@Lyall0, that's fine, IRL comes first. I believe that the page isn't far off from GA status, I am just pinging you to make sure you're active. I am more than willing to accommodate for extra time, just keep me in the know. 🏵️Etrius ( Us) 02:57, 6 March 2023 (UTC)

@Lyall0, It has been over a week. I am willing to accommodate IRL obligations but I do expect you to be actively working on the page, or at least to keep me informed of a rough timeline. I'll leave this open for a few more days but if I don't hear back or see any progress, I will fail the nomination for lack of activity. Please, Please, Please reach out if you have any concerns/questions about the GA process. I don't like seeing pages fail, most reviewers are rooting for the nominators, but I also can't keep an inactive review open indefinitely. 🏵️Etrius ( Us) 14:13, 9 March 2023 (UTC)

Sorry it's been a very busy past week for me. I've just done a few updates now and should have time for more this week. Lyall0 (talk) 00:04, 13 March 2023 (UTC)

@Lyall0 I apologize for nagging but it has been another week without any progress. I see that a few edits to the lead have been made and I like the improvements so far, but this review is over 2 weeks. Again, I do expect steady work on the GA nomination. Unless there is communication about real-life obligations or significant work performed I will fail it outright in the next few days. I'm fighting to keep this alive but won't keep pushing. Should this page remain inactive or should there be another long period of inactivity following a few edits, then I will fail it. I'll set the end of March as a hard stop for the review should the current editing pattern continue. 🏵️Etrius ( Us) 01:24, 21 March 2023 (UTC)

@Etriusus Sorry I think this was a miscalculation on my part. When I submitted the article for GA review I had more free time to put in but I simply haven't had the time recently. I really apologize for the flaking out on this—I very much appreciate the work you put it to provide feedback, and I'll still work to address it when I have more time so it's not all for nothing. Please feel free to fail the review. I'll endeavor to do better next time. Lyall0 (talk) 06:48, 23 March 2023 (UTC)

@Lyall0 Understood, when you feel as through it is ready again, you can renominate the page. You don't need to beat yourself up over it, lord knows I failed my first few GA noms. If you want me to pick this back up at a later time, feel free to ping me and I'll gladly continue the review. Thank you for all the work you've done so far and I look forward to see your future work. Cheers, 🏵️Etrius ( Us) 17:12, 24 March 2023 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

References