The association between allergy and chronic rhinosinusitis with and without nasal polyps: an evidence‐based review with recommendations

Wilson, Kevin F.; McMains, Kevin C.; Orlandi, Richard R.

doi:10.1002/alr.21258

Cited by 109 publications

(102 citation statements)

References 29 publications

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“…The prevalence of AR + SwNP found in our survey is in line with the estimated prevalence found both in Europe, which ranged from 2 to 4% of the general population [22], and that found in a specific survey in France (2.1%) [23]. However, other studies [24] found a higher prevalence of polyposis than our survey, which could be due to the fact that it was not in a population-based study.…”

Section: Discussionsupporting

confidence: 90%

“…The overlap between allergic and non-allergic upper airways diseases has been discussed in clinical studies, but its epidemiological results remain controversial and poorly defined [13,14,15]. This study aimed to evaluate the prevalence of AR, AR with sinusitis without NP (AR + SsNP) and AR with sinusitis with NP (AR + SwNP), and investigate whether the interaction between AR and bronchial asthma is affected by concomitant upper airway diseases.…”

Section: Introductionmentioning

confidence: 99%

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The Heterogeneity Hidden in Allergic Rhinitis and Its Impact on Co-Existing Asthma in Adults: A Population-Based Survey

Antonicelli

Marchetti

Accordini

et al. 2015

Int Arch Allergy Immunol

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Background: It has been suggested that there is some overlap between allergic rhinitis (AR), sinusitis and polyposis, but this has not been fully documented. The present study aimed to evaluate the prevalence of these co-existing diseases and their impact on bronchial asthma in the general population of Italy. Methods: Within the frame of the multicentre Gene Environment Interactions in Respiratory Diseases (GEIRD) study, a postal screening questionnaire including questions about self-reported symptoms of asthma, AR, AR with sinusitis without nasal polyps (AR + SsNP) and AR with sinusitis with nasal polyps (AR + SwNP) was administered. Random samples of subjects aged between 20 and 44 years (n = 5,162) answered the postal questionnaire in 4 Italian centres (Pavia, Sassari, Turin, Verona). In AR subjects, the association among AR only, AR + SsNP, AR + SwNP and bronchial asthma was estimated by the relative risk ratio (RRR) using multinomial regression models. Results: The prevalence of AR in the sample was 25.4% (95% CI 24.2-26.6). A self-reported diagnosis of AR + SsNP and AR + SwNP was reported by 5.7% (95% CI 5.0-6.3) and by 1.2% (95% CI 0.9-1.5) of the subjects, respectively. Current asthma was reported by 17.5% of the AR subjects. In the adjusted multivariate analysis, the risk of having current asthma (RRR = 2.31, 95% CI 1.29-4.15), of having at least 1 asthma attack per year (RRR = 2.30, 95% CI 1.19-4.46) and of having had an emergency department admission for respiratory diseases (RRR = 5.61, 95% CI 1.81-23.92) was higher for subjects with AR + SwNP than subjects with AR only. Conclusions: The diagnosis of AR in the epidemiological setting includes heterogeneous upper airway diseases that affect the clinical features of AR and its interactions with asthma.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The Heterogeneity Hidden in Allergic Rhinitis and Its Impact on Co-Existing Asthma in Adults: A Population-Based Survey

Antonicelli

Marchetti

Accordini

et al. 2015

Int Arch Allergy Immunol

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“…293 Because the pathophysiology of CRSsNP is in many ways still unclear, it is difficult to evaluate the role of allergies in this type of CRS when there are no controlled studies published. 7 In 2014, Wilson et al 322 reviewed the role of allergy in CRSwNP and CRSsNP. They considered only studies that delineated the presence of polyps or not, so that studies examining "CRS" alone were excluded.…”

Section: Viib Crssnp: Comorbid Asthmamentioning

confidence: 99%

“…Asthma as a comorbidity should be considered during the evaluation of a patient with CRSwNP. 322 reviewed the role of allergy in CRSwNP and CRSsNP. They considered only studies that delineated the presence of polyps or not, so that studies examining "CRS" alone were excluded.…”

Section: Viiib Crswnp: Comorbid Asthmamentioning

confidence: 99%

“…Taking the totality of these studies into account, Wilson et al 322 concluded that allergy testing should be considered an option in CRSwNP patients, inasmuch as there was a theoretical benefit of finding inflammatory triggers, there is little harm, and the low aggregate LOE did not support a strong recommendation either for or against this practice.…”

Section: Viiib Crswnp: Comorbid Asthmamentioning

confidence: 99%

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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

Self Cite

557

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Medical Therapies for Adult Chronic Sinusitis

Rudmik

Soler

2015

JAMA

137

129

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The association between allergy and chronic rhinosinusitis with and without nasal polyps: an evidence‐based review with recommendations

Abstract: The role of allergy in CRSwNP and CRSsNP continues to be controversial, with the level of evidence poor. Based on the available data, the recommendation is that allergy testing and treatment are an option in CRSwNP and CRSsNP.

Cited by 109 publications

References 29 publications

The Heterogeneity Hidden in Allergic Rhinitis and Its Impact on Co-Existing Asthma in Adults: A Population-Based Survey

The Heterogeneity Hidden in Allergic Rhinitis and Its Impact on Co-Existing Asthma in Adults: A Population-Based Survey

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Medical Therapies for Adult Chronic Sinusitis

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