Socioeconomic, comorbidity, lifestyle, and quality of life comparisons between chronic rhinosinusitis phenotypes

Philpott, Carl; Ta, Ngan Hong; Hopkins, Claire; Ray, Jaydip; Ahmed, Shazhada; Almeyda, Robert; Kara, Naveed; Carrie, Sean; Erskine, Sally; Cathcart, Russell; Sunkaraneni, Vishnu; Robertson, Alasdair; Anari, Shahram; Kumar, B Nirmal; Clark, Allan

doi:10.1002/lary.29527

Cited by 9 publications

(9 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The burden of rhinitis 2 and CRS 3,4 on the health care system and economy is well‐established, and it manifests in increased annual medical expenditure and loss of productivity. Similar findings were also observed in our young adults cohort with increased annual visits to both primary care physicians and otorhinolaryngological consultations compared to a controlled group.…”

Section: Discussionmentioning

confidence: 99%

“…Rhinitis and chronic rhinosinusitis (CRS) are extremely common conditions, affecting approximately 30% of the adult population. 1 Both have been well-documented to impact patients' well-being and productivity [2][3][4] as well as increasing health care utilization and increased spending on medications among patients. Moreover, rhinitis and CRS appear to be risk factors for asthma, 1,5,6 further impacting patient's health and health care consumption.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Long‐Term Implications of Rhinitis and Chronic Rhinosinusitis in Young Adults

2023

View full text Add to dashboard Cite

BackgroundThe long‐term impact of rhinitis and chronic rhinosinusitis (CRS) on general health and medical services utilization in young adults have been limitedly studied.MethodsA case–control study in the Israeli Defense Forces, between the years 2005 and 2019, of all individuals with either rhinitis or CRS and a matched cohort of healthy individuals with a minimum of 5 years of consecutive follow‐up.ResultsThe study groups included 617 patients with rhinitis and 296 patients with CRS and 2739 healthy controls with an average age of 28 years. During a mean follow‐up of 8 years, a significant fraction of patients in both study groups were diagnosed with asthma compared to the control group, (26.1% and 23.3% vs. 3.7%, respectively; CI 95%: 12.1%–14.9%, p < 0.0001). 7.6% of patients with rhinitis developed CRS. Significantly increased loss of productivity and medical system utilization were noted in the study groups compared to controls (p < 0.0001). Moreover, deterioration in general health, manifested as loss of physical fitness for combative service was observed in a third of patients during follow‐up.ConclusionsRhinitis and CRS significantly impact productivity and medical service utilization in young adults, as well as general health associated with development of asthma and impairment of physical fitness. A minority of rhinitis patients develop CRS overtime, further affecting this patient group. These patients should be followed up and managed to improve disease control and associated outcomes.Level of Evidence3 Laryngoscope, 2023

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Long‐Term Implications of Rhinitis and Chronic Rhinosinusitis in Young Adults

2023

View full text Add to dashboard Cite

show abstract

“…CRSwNP and asthma often coexist, with studies indicating that between 40% and 67% of patients with CRSwNP have coexisting asthma. [4][5][6][7] CRSwNP is associated with a significant clinical, health-related quality of life (HRQoL) and economic burden. [8][9][10] Those with coexisting asthma have a more severe CRSwNP disease burden and tend to have poorer outcomes for both CRSwNP and asthma than patients without the coexisting condition, adding to the treatment challenge.…”

Section: Introductionmentioning

confidence: 99%

Dupilumab Improves Outcomes in Patients with Chronic Rhinosinusitis with Nasal Polyps and Coexisting Asthma Irrespective of Baseline Asthma Characteristics

Busse¹,

Pavord²,

Siddiqui³

et al. 2023

JAA

View full text Add to dashboard Cite

Purpose Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease frequently coexisting with other type 2 conditions including asthma and non-steroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD). Coexisting asthma leads to increased CRSwNP symptom burden. Dupilumab, a monoclonal antibody that blocks the shared receptor component for interleukin-4 and -13, demonstrated efficacy in adults with severe CRSwNP in the Phase 3 SINUS-24 (NCT02912468) and SINUS-52 (NCT02898454) studies, including in patients with coexisting asthma/NSAID-ERD. However, the impact of different asthma characteristics on dupilumab treatment in this population is unknown. We report CRSwNP and asthma outcomes with dupilumab in patients with CRSwNP and coexisting asthma according to baseline asthma characteristics. Methods Change from baseline at Week 24 (pooled studies) and Week 52 (SINUS-52) in CRSwNP outcomes (nasal polyp score, nasal congestion, 22-item Sino-Nasal Outcome Test [SNOT-22], loss of smell score, University of Pennsylvania Smell Identification Test) and asthma outcomes (5-item Asthma Control Questionnaire [ACQ-5], pre-bronchodilator forced expiratory volume in 1 second [FEV 1 ]) were analyzed post hoc for placebo and dupilumab 300 mg every 2 weeks according to baseline blood eosinophils ≥150/≥300 cells/µL, ACQ-5 scores <1.5/≥1.5, and FEV 1 <80%. Results In the pooled studies, 428/724 patients (59.1%) had coexisting asthma, of which 181/428 (42.3%) had coexisting NSAID-ERD. Dupilumab significantly improved all CRSwNP and asthma outcomes vs placebo at Week 24 (P < 0.001) regardless of baseline eosinophil or ACQ-5 category, or FEV 1 <80%. Similar magnitude of improvement was seen at Week 52 (SINUS-52) and in patients with NSAID-ERD (pooled studies, Week 24). By Week 24, improvements with dupilumab exceeded the minimum clinically important differences for ACQ-5 and SNOT-22 in 35.2% to 74.2% and 72.0% to 78.7% of patients, respectively. Conclusion Dupilumab improved CRSwNP outcomes in patients with CRSwNP and coexisting asthma, and improved asthma outcomes, regardless of differences in baseline asthma characteristics.

show abstract

“…1 Hallmark symptoms of rhinitis include nasal obstruction or congestion, nasal discharge (anterior and/or posterior), facial pain or pressure, and dysosmia. 2 Allergic rhinitis (AR), the most common and recognizable phenotype, is linked to an immunoglobulin E-mediated inflammatory response which results in swelling and hyperreactivity of the nasal mucosa. 3 Non-allergic rhinitis (NAR) is a heterogeneous collection of distinct pathophysiological subtypes causing similar rhinologic symptoms, in the absence of allergic triggers.…”

Section: Introductionmentioning

confidence: 99%

“…Chronic rhinitis is persistent inflammation of the nasal mucosa and is clinically classified as non‐allergic, allergic, or mixed (of both allergic and non‐allergic triggers) etiologies 1 . Hallmark symptoms of rhinitis include nasal obstruction or congestion, nasal discharge (anterior and/or posterior), facial pain or pressure, and dysosmia 2 . Allergic rhinitis (AR), the most common and recognizable phenotype, is linked to an immunoglobulin E‐mediated inflammatory response which results in swelling and hyperreactivity of the nasal mucosa 3 .…”

Section: Introductionmentioning

confidence: 99%

Intranasal Anticholinergics for Treatment of Chronic Rhinitis: Systematic Review and Meta‐Analysis

Pang

Vasudev

et al. 2022

The Laryngoscope

View full text Add to dashboard Cite

Objective Topical intranasal anticholinergics are commonly prescribed for the relief of chronic rhinitis and associated symptoms, warranting thorough assessment of the supporting evidence. The present study aimed to evaluate the safety and efficacy of anticholinergic nasal sprays in the management of allergic and non‐allergic rhinitis symptom severity and duration. Methods A search encompassing the Cochrane Library, PubMed/MEDLINE, and Scopus databases was conducted. Primary studies describing rhinorrhea, nasal congestion, and/or postnasal drip outcomes in rhinitis patients treated with an anticholinergic spray were included for review. Results The search yielded 1,029 unique abstracts, of which 12 studies (n = 2,024) met inclusion criteria for qualitative synthesis and 9 (n = 1,920) for meta‐analysis. Median follow‐up was 4 weeks and ipratropium bromide was the most extensively trialed anticholinergic. Compared to placebo, anticholinergic treatment was demonstrated to significantly reduce rhinorrhea severity scores (standardized mean difference [95% CI] = −0.77 [−1.20, −0.35]; −0.43 [−0.72, −0.13]) and duration (−0.62 [−0.95, −0.30]; −0.29 [−0.47, −0.10]) in allergic and non‐allergic rhinitis patients respectively. Benefit was less consistent for nasal congestion, postnasal drip, and sneezing symptoms. Reported adverse effects included nasal mucosa dryness or irritation, epistaxis, headaches, and pharyngitis, though comparison to placebo found significantly greater risk for epistaxis only (risk ratio [95% CI] = 2.19 [1.22, 3.93]). Conclusion Albeit treating other symptoms with less benefit, anticholinergic nasal sprays appear to be safe and efficacious in reducing rhinorrhea severity and duration in both rhinitis etiologies. This evidence supports their continued use in the treatment of rhinitis‐associated rhinorrhea. Level of Evidence 1 Laryngoscope, 133:722–731, 2023

show abstract

Socioeconomic, comorbidity, lifestyle, and quality of life comparisons between chronic rhinosinusitis phenotypes

Cited by 9 publications

References 38 publications

The Long‐Term Implications of Rhinitis and Chronic Rhinosinusitis in Young Adults

The Long‐Term Implications of Rhinitis and Chronic Rhinosinusitis in Young Adults

Dupilumab Improves Outcomes in Patients with Chronic Rhinosinusitis with Nasal Polyps and Coexisting Asthma Irrespective of Baseline Asthma Characteristics

Intranasal Anticholinergics for Treatment of Chronic Rhinitis: Systematic Review and Meta‐Analysis

Contact Info

Product

Resources

About