A real-world assessment of asthma with chronic rhinosinusitis

Ricciardolo, Fabio Luigi Massimo; Levra, Stefano; Sprio, Andrea Elio; Bertolini, Francesca; Carriero, Vitina; Gallo, Fabio; Ciprandi, Giorgio

doi:10.1016/j.anai.2020.03.004

Cited by 19 publications

(15 citation statements)

References 33 publications

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“…The prevalence of asthma in the general population is around 5% while it scales to 25% in patients with CRS and between 20% and 45% in patients with CRSwNP 196,1347 . Two perspectives need to be considered: patients with CRSwNP suffering from asthma and asthmatic patients developing CRSwNP.…”

Section: Chronic Rhinosinusitis With Nasal Polyps (Crswnp)mentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

518

479

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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Section: Chronic Rhinosinusitis With Nasal Polyps (Crswnp)mentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

518

479

View full text Add to dashboard Cite

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“…2,3,5 In patients with chronic rhinosinusitis with nasal polyps (CRSwNP), type 2edriven asthma is the most common inflammatory comorbidity, with up to 67% of patients with CRSwNP having concomitant asthma; in patients with severe CRSwNP, the incidence of asthma is even higher. [6][7][8][9][10][11] In contrast, nasal polyps are more common in patients with severe, late-onset asthma (polyps often precede the onset of asthma), with up to 39% of patients with late-onset asthma having nasal polyps. [12][13][14][15][16] Patients with CRSwNP and comorbid asthma have a higher disease burden than patients with CRSwNP alone, with more severe nasal obstruction and loss of smell, poor asthma control and lung function, worse health-related quality of life (HRQoL), and higher associated health care costs.…”

Section: Introductionmentioning

confidence: 99%

Dupilumab improves upper and lower airway disease control in chronic rhinosinusitis with nasal polyps and asthma

Laidlaw

Bachert

Amin

et al. 2021

Annals of Allergy, Asthma & Immunology

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Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) and type 2 asthma share the same inflammatory pathophysiology and are frequent comorbidities. Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin 4 and interleukin 13, which are key and central drivers of type 2 inflammation. Objective: We report the effect of dupilumab vs placebo on outcome measures of the upper and lower airways and health-related quality of life (HRQoL) in the pooled population of patients with CRSwNP and comorbid asthma from the phase 3 SINUS-24 (NCT02912468) and SINUS-52 (NCT02898454) studies. Methods: In these randomized, double-blind, placebo-controlled trials, patients received subcutaneous dupilumab 300 mg (n ¼ 438) or placebo (n ¼ 286) every 2 weeks on a background of mometasone furoate

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“…Despite the similar risk of severe exacerbations in the persistently high and intermittently high BEC groups, there were notable areas of divergence. Compared with the intermittently high group, patients in the persistently high group had a greater prevalence of nasal polyps (5.1% vs 10.8%), a condition known to be associated with eosinophil elevations 34 and an independent predictor of severe asthma exacerbation risk in our analysis. For patients who never smoked, persistently high BEC was associated with a significantly greater risk of severe exacerbations compared with the intermittently high group.…”

Section: Discussionmentioning

confidence: 72%

Persistence of Eosinophilic Asthma Endotype and Clinical Outcomes: A Real-World Observational Study

Tran

Kerkhof²,

Carter

et al. 2021

JAA

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Purpose Eosinophil count elevations are predictive of adverse outcomes in patients with asthma, yet little is known regarding longitudinal eosinophil patterns and their association with clinical outcomes. The goal of this study was to assess associations between longitudinal persistence of eosinophil elevations and both clinical outcomes and health care resource utilization (HCRU). Methods Data were extracted from 2 databases in the United Kingdom. Patients included were aged ≥13 years, had active asthma, and had ≥3 blood eosinophil count (BEC) recordings. Patients were categorized by BEC as: never high (all BEC ≤300 cells/µL), intermittently high (≥1 BEC >300 cells/µL but <75% of BEC >300 cells/µL), or persistently high (≥75% of BEC >300 cells/µL). Asthma exacerbations, asthma control (risk domain, overall, and full), and HCRU were evaluated for 12 months after the last BEC. Results The study population comprised 148,021 patients. Persistently high, intermittently high, and never high eosinophil patterns were detected in 13.6%, 40.5%, and 45.9% of patients, respectively. Patients with ≥1 elevated BEC were at greater risk for severe asthma exacerbations, regardless of whether the elevation was persistent (rate ratio [RR]: 1.28 [95% CI 1.24–1.33]; P < 0.001) or intermittent (RR: 1.24 [95% CI 1.21–1.27]; P < 0.001), compared with patients with no eosinophil elevations. Full asthma control was achieved by <25% of patients across eosinophil pattern groups, and HCRU did not appreciably differ, although patients with persistently high BEC had the shortest hospital stay duration among the groups. Conclusion These data suggest that elevated blood eosinophils, regardless of persistency, signify increased risk of severe asthma exacerbations.

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A real-world assessment of asthma with chronic rhinosinusitis

Cited by 19 publications

References 33 publications

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Dupilumab improves upper and lower airway disease control in chronic rhinosinusitis with nasal polyps and asthma

Persistence of Eosinophilic Asthma Endotype and Clinical Outcomes: A Real-World Observational Study

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