Management of Chronic Rhinosinusitis with Nasal Polyps and Coexisting Asthma: A Systematic Review

Rix, Iben; Håkansson, Kåre; Larsen, Christian Grónhøj; Frendø, Martin

doi:10.2500/ajra.2015.29.4178

Cited by 64 publications

(53 citation statements)

References 33 publications

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“…The prevalence of NP among patients with diagnosed CRS in the US varies from 25% to 30% . Additionally, CRS and asthma are strongly associated with a 50% asthma prevalence in patients with CRSwNP …”

Section: Introductionmentioning

confidence: 99%

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Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Villeneuve²,

et al. 2019

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Objectives/Hypothesis Establish treatment patterns and economic burden in US patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) versus without chronic rhinosinusitis (CRS). Determine comparative costs of subgroups with high clinical burden. Study Design Observational, retrospective, case‐control study. Methods This study matched patients with CRSwNP to patients without CRS (1:1) using the Truven Health MarketScan US claims database. Categorical and continuous variables were compared using McNemar test and paired t test (normal distribution) or Wilcoxon signed rank tests (non‐normal distribution). Within subgroups, χ2 and Wilcoxon or t tests were used (normal distribution). Results There were 10,841 patients with CRSwNP and 10,841 patients without CRS included. Mean age in the CRSwNP cohort was 45.8 years; 56.2% were male. During follow‐up, patients with CRSwNP had an increased diagnosis of asthma versus patients without CRS (20.8% vs. 8.1%, respectively; P < .001). Annual incremental costs were $11,507 higher for patients with CRSwNP versus those without CRS. Costs were higher in subgroups of patients with CRSwNP undergoing functional endoscopy sinus surgery (FESS), with a comorbid diagnosis of asthma, receiving oral corticosteroids, or macrolides versus the overall CRSwNP group. Patients with CRSwNP undergoing FESS had the highest costs of the four subgroups ($26,724, $22,456, $20,695, and $20,990, respectively). Conclusions Annual incremental costs were higher among patients with CRSwNP versus without CRS. Patients with CRSwNP with high clinical burden had higher overall costs than CRSwNP patients without. Level of Evidence NA Laryngoscope, 129:1969–1975, 2019

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Section: Introductionmentioning

confidence: 99%

“…Furthermore, nasal polyposis recurrence is common following surgery, which could also increase patient care costs. As CRSwNP frequently coexists with asthma, medical management may extend further than CRSwNP treatment, increasing patient care costs.…”

Section: Introductionmentioning

confidence: 99%

Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Villeneuve²,

et al. 2019

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“…Erythromycin improved nasal symptoms and was superior to ESS in relation to pulmonary outcomes, but they concluded that all nasal outcomes and QOL improved significantly in the surgical studies. Risk of bias for all interventions leads to the strength of evidence to be considered low [55]. In a prospective randomised study, the effect of surgical and medical management (topical corticosteroids, decongestant and alkaline nasal douche) of CRS on concomitant asthma control was investigated.…”

Section: Comparative Evidence Between Medical and Surgical Interventionsmentioning

confidence: 99%

Surgical Versus Medical Interventions in CRS and Nasal Polyps: Comparative Evidence Between Medical and Surgical Efficacy

Dessouky

Hopkins

2015

Curr Allergy Asthma Rep

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CRS with nasal polyps (CRSwNP) is a subgroup of CRS, where polyps can be visualised in the middle meatus. In the general population, the prevalence is estimated to lie between 0.2 and 4 %. Up to 15 % of patients with asthma have nasal polyps and up to 45 % of patients with nasal polyps have asthma. The management of CRSwNP involves primary medical management, with surgery normally reserved for recalcitrant cases. Surgical techniques for CRSwNP range from simple polypectomy and endoscopic sinus surgery (ESS) to radical nasalisation with removal of the middle turbinates. We have reviewed the comparative literature regarding medical and surgical interventions in CRSwNP, with emphasis on outcomes, complications, cost-effectiveness and on the timing of surgery. Similar outcomes are reported for medical and surgical management, but there is sufficient evidence to support the role of surgery once symptoms have failed to adequately respond. There is insufficient evidence to define the optimal timing and extent of surgery.

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“…Asthma is the most common chronic disease affecting children, and is characterized by reversible airflow obstruction and chronic inflammation of the airways (Quirce et al, 2015;Rix et al, 2015). Asthma is a heterogeneous disease involving both genetic and environmental factors (Custovic et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Association between a functional single nucleotide polymorphism in the brain-derived neurotrophic factor gene and risk of child asthma

Jy¹,

Al²,

Zl³

2015

Genet. Mol. Res.

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ABSTRACT. Brain-derived neurotrophic factor (BDNF) promotes synaptic remodeling and modulates the function of other neurotransmitters. Allergic inflammation triggers neuronal dysfunction and structural changes in the airways. Genetic polymorphisms in functional regions of the BDNF gene have a plausible role in modulating the risk of child asthma (CA). This study examined the potential association between CA and three single nucleotide polymorphisms (SNPs) in BDNF (rs2030323, rs6265, and rs16917204 in the promoter, exon 4, and 3'-untranslated regions, respectively). The study was conducted in 350 children with asthma and 356 healthy controls. The genotype and allele frequencies and difference between groups were analyzed using HaploView 4.0 and SPSS 20.0 software platforms. The analysis revealed a strong association between the rs6265 genotype distribution and CA. The frequency of the G allele was significantly higher 16233-16240 (2015) in CA patients than in healthy controls (P = 0.0007, odds ratio = 1.323, 95% confidence interval = 1.073-1.632). Strong linkage disequilibrium was observed between rs16917204 and rs6265. A significantly higher number of G-G haplotypes were observed in CA patients than in controls (P = 0.024 after Bonferroni correction), while the G-A haplotypes were more significant in controls (P = 0.013 after Bonferroni correction). This suggested that BDNF gene polymorphisms confer susceptibility to CA, and also support the notion that BDNF dysfunction is involved in the pathophysiological process of CA.

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Management of Chronic Rhinosinusitis with Nasal Polyps and Coexisting Asthma: A Systematic Review

Cited by 64 publications

References 33 publications

Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Surgical Versus Medical Interventions in CRS and Nasal Polyps: Comparative Evidence Between Medical and Surgical Efficacy

Association between a functional single nucleotide polymorphism in the brain-derived neurotrophic factor gene and risk of child asthma

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