Systematic literature review of the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyposis

Chen, Stephanie; Zhou, Anna; Emmanuel, Benjamin; Kim, Thomas; Guiang, Hannah

doi:10.1080/03007995.2020.1815682

Cited by 70 publications

(61 citation statements)

References 98 publications

(149 reference statements)

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“…This initiative of the PAB of EUFOREA provides unique insights into the burden of CRSwNP, patients' views on the strengths and shortcomings of the current care pathways and patients' priorities and preferences to overcome these unmet needs in future CRS management. CRS patients reported some very important insights in addition to the classic CRSwNP symptoms presented in previously reported studies (2,18). They noted impaired sleep quality, along with mental dysfunction and reduced smell capacity, as the most frustrating aspects of the disease.…”

Section: Discussionmentioning

confidence: 83%

“…Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) represents a chronic inflammatory condition of the nose and paranasal sinus cavities with major impact on well-being and social function which is greatest in the young adult to middle aged populations (1). With an estimated prevalence of 3%, CRSwNP represents a common health problem in the Western world (1,2). Despite international evidence-based guidelines for treatment (EPOS2020), a substantial group of patients remain uncontrolled with recurrent needs of oral corticosteroids (OCS) and/or endoscopic sinus surgery (ESS) (3).…”

Section: Introductionmentioning

confidence: 99%

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Patients Unmet Needs in Chronic Rhinosinusitis With Nasal Polyps Care: A Patient Advisory Board Statement of EUFOREA

et al. 2021

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Background: European patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have had only limited occasions to unite to have their voices heard, hence missing the opportunity to contribute to the improvement of CRSwNP care.Aims: To identify unmet needs in CRSwNP from the perspective of CRSwNP patients from the Patient Advisory Board (PAB) of the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA).Methodology: Semi-structured interviews were conducted individually with 15 European patients with CRSwNP and with a disease history of more than 2 years. Patients shared their burden of the disease and frustrations related to CRSwNP care, experiences with key pillars of current treatment options, shortcomings of the current care pathways and recommendations for improvement of care. A panel of 30 members of the Patient Advisory Board reviewed the interview report and provided further input during 2 virtual meetings.Results: CRSwNP patients indicated the need for greater awareness from society and physicians of the disease burden with impact on social function and well-being. Along with a loss of ability to smell and the continuous presence of secretions in the nose, most patients reported poor sleep quality and psychological impact as the most bothersome symptoms. Patients' frustrations relate primarily to the underestimation of the disease burden, the lack of coordination of care and the limited treatment options available to them. Treatment options with oral corticosteroids and/or sinus surgery both have positive and negative aspects, including the lack of long-lasting efficacy. Better coordination of care, more patient-centered care, greater public awareness, increases in research on the disease mechanisms and better therapeutic options would be warmly welcomed by CRSwNP patients.Conclusions: This statement of the EUFOREA Patient Advisory Board on CRSwNP provides novel insights on the underestimation of the burden of CRSwNP and shortcomings of current care. Multiple recommendations made by the patients can underpin action plans for implementation of better care for CRSwNP among all physicians treating patients with this disabling disease.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Patients Unmet Needs in Chronic Rhinosinusitis With Nasal Polyps Care: A Patient Advisory Board Statement of EUFOREA

et al. 2021

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“…1,2 CRSwNP affects 1% to 3%, 3,4 and comorbid asthma and allergic rhinitis is common. 5 Approximately 10% of patients with CRSwNP have aspirin-exacerbated respiratory disease (AERD), eponymously known as the Samter triad: potentially life-threatening aspirin/nonsteroidal antiinflammatory drug hypersensitivity, CRSwNP, and asthma. 6 Medical therapies for CRSwNP have historically relied on nasal saline rinse and intranasal steroids in various delivery forms (sprays, high-volume irrigation, exhalation delivery) 7,8 until treatment failure and/or disease flare triggered rescue oral corticosteroids (OCS) and/or endoscopic sinus surgery.…”

mentioning

confidence: 99%

Comparative efficacy and safety of monoclonal antibodies and aspirin desensitization for chronic rhinosinusitis with nasal polyposis: A systematic review and network meta-analysis

Oykhman

Paramo

Bousquet

et al. 2022

Journal of Allergy and Clinical Immunology

147

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Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammatory condition of the upper airways. Optimal management is unclear. Objective: We compared the effects of mAbs and aspirin desensitization (ASA-D) for treatment of CRSwNP. Methods: We searched the Medline, Embase, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform, US Food and Drug Administration, and the European Medicines Agency databases from inception to August 4, 2021, for randomized controlled trials comparing the effects of mAbs and ASA-D for CRSwNP. We conducted network meta-analysis of sinusitis symptoms, heath-related quality of life, rescue oral corticosteroids and surgery, endoscopic and radiologic scores, and adverse events. We used the Grades of Recommendation Assessment, Development and Evaluation (GRADE) approach to assess certainty of evidence. PROSPERO CRD42020177334. Results: Twenty-nine randomized controlled trials evaluating 8 treatments (n 5 3461) were included in the network metaanalysis. Compared to placebo, moderate to high certainty evidence showed that health-related quality of life (SNOT-22) improved with dupilumab (mean difference [MD] 219.91 [95%

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“…This is an outgrowth of tissue that arises into the nasal cavity (Schleimer, 2017). The prevalence of the disease is estimated between 1-4% of the population (Fokkens et al, 2012;Chen et al, 2020). Symptoms include nasal blockage and itching, rhinorrhea, sneezing, facial pain, headache and smell impairment or loss (Georgy and Peters, 2012;Chen et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of the disease is estimated between 1-4% of the population (Fokkens et al, 2012;Chen et al, 2020). Symptoms include nasal blockage and itching, rhinorrhea, sneezing, facial pain, headache and smell impairment or loss (Georgy and Peters, 2012;Chen et al, 2020). Treatment starts with intranasal topic corticosteroids in the milder cases, followed by surgical extirpation or biological drugs, such as omalizumab, in the most severe ones (Lund, 1995;Georgy and Peters, 2012).…”

Section: Introductionmentioning

confidence: 99%

Understanding Systemic and Local Inflammation Induced by Nasal Polyposis: Role of the Allergic Phenotype

Delgado-Dolset

Obeso

Sánchez-Solares

et al. 2021

Front. Mol. Biosci.

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Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by persistent symptoms associated to the development of nasal polyps. To this day, the molecular mechanisms involved are still not well defined. However, it has been suggested that a sustained inflammation as allergy is involved in its onset. In this exploratory study, the aim was to investigate the effect of the allergic status in the development of CRSwNP. To achieve this, we recruited 22 patients with CRSwNP and classified them in non-allergic and allergic using ImmunoCAP ISAC molecular diagnosis. Plasma samples were analyzed using liquid chromatography coupled to mass spectrometry (LC-MS). Subsequently, significant metabolites from plasma that were commercially available were then analyzed by targeted analysis in some nasal polyps. Additionally, nasal polyp and nasal mucosa samples were examined for eosinophils, neutrophils, CD3+ and CD11c+ cells, as well as collagen deposition and goblet cell hyperplasia. We found that 9 out of the 22 patients were sensitized to some aeroallergens (named as allergic CRSwNP). The other 13 patients had no sensitizations (non-allergic CRSwNP). Regarding metabolomics, bilirubin, cortisol, lysophosphatidylcholines (LPCs) 16:0, 18:0 and 20:4 and lysophosphatidylinositol (LPI) 20:4, which are usually related to a sustained allergic inflammation, were unexpectedly increased in plasma of non-allergic CRSwNP compared to allergic CRSwNP. LPC 16:0, LPC 18:0 and LPI 20:4 followed the same trend in nasal polyp as they did in plasma. Comparison of nasal polyps with nasal mucosa showed a significant increase in eosinophils (p < 0.001) and neutrophils (p < 0.01) in allergic CRSwNP. There were more eosinophils in polyps of non-allergic CRSwNP than in their nasal mucosa (p < 0.01). Polyps from non-allergic CRSwNP had less eosinophils than the polyps of allergic CRSwNP (p < 0.05) and reduced amounts of collagen compared to their nasal mucosa (p < 0.001). Our data suggests that there is a systemic inflammatory response associated to CRSwNP in the absence of allergy, which could be accountable for the nasal polyp development. Allergic CRSwNP presented a higher number of eosinophils in nasal polyps, suggesting that eosinophilia might be connected to the development of nasal polyps in this phenotype.

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Systematic literature review of the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyposis

Cited by 70 publications

References 98 publications

Patients Unmet Needs in Chronic Rhinosinusitis With Nasal Polyps Care: A Patient Advisory Board Statement of EUFOREA

Patients Unmet Needs in Chronic Rhinosinusitis With Nasal Polyps Care: A Patient Advisory Board Statement of EUFOREA

Comparative efficacy and safety of monoclonal antibodies and aspirin desensitization for chronic rhinosinusitis with nasal polyposis: A systematic review and network meta-analysis

Understanding Systemic and Local Inflammation Induced by Nasal Polyposis: Role of the Allergic Phenotype

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