The burden of chronic rhinosinusitis with nasal polyps and its relation to asthma in Finland

Toppila‐Salmi, Sanna; Hällfors, Jenni; Aakko, Juhani; Mannerström, Bettina; Nieminen, Kaisa; Telg, Gunilla; Lehtimäki, Lauri

doi:10.1002/clt2.12200

Cited by 9 publications

(6 citation statements)

References 52 publications

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“…Additionally, it was revealed that the relative proportion of pediatric and adult CRSwNP patients who underwent baseline ESS was 47% and 48%, respectively. In Finland, the reported nationwide average ESS rate is 0.71 per 1000 inhabitants, 39 and a recent study showed that among 18,600 CRSwNP patients in Finland, ESS was performed for 47% of the patients 40 . Therefore, our findings might reflect a comparable prevalence of ESS among CRS patients.…”

Section: Discussionsupporting

confidence: 47%

Comorbidities of chronic rhinosinusitis in children and adults

Murtomäki,

Helevä,

Torkki

et al. 2024

Clinical & Translational All

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BackgroundChronic rhinosinusitis (CRS) is a chronic inflammatory disease of the nose and paranasal sinuses lasting ≥12 weeks. CRS may exist with (CRSwNP) or without (CRSsNP) nasal polyps. The aim was to evaluate conditions associated with CRS in a randomized hospital cohort. We hypothesized that comorbidities and surgical procedures differ between pediatric and adult patients.MethodsThis study consisted of hospital registry data of a random sample of rhinosinusitis patients (age range 0–89 years) with the diagnosis of J32 or J33, correspondingly, registered during outpatient visits from 2005 to 2019 (n = 1461). The covariates of interest were collected from electronic health records based on ICD‐10 codes and keyword searches.ResultsAmong pediatric patients (n = 104), the relative proportions of CRSsNP and CRSwNP were 86% and 14% respectively. The relative proportions of adult patients (n = 1357) with CRSsNP and CRSwNP were 60% and 40%, respectively. The following comorbidities significantly differed (p < 0.05) between pediatric and adult populations: allergy, chronic otitis media, and tonsillar diseases. In total, 41 % of the children and 46% of the adults underwent baseline endoscopic sinus surgery (ESS). Additional surgeries of the ear, nose and pharynx were significantly more common among children compared with adults. Risk of revision after baseline ESS was associated (p < 0.05) with allergy, asthma, eosinophilia, CRSwNP, immunodeficiency or its suspicion, non‐steroidal anti‐inflammatory drug exacerbated respiratory disease, and number of any diseases ≥2.ConclusionsOur study showed that comorbidities differ between pediatric and adult rhinosinusitis patients, as allergy, asthma and allergy, chronic otitis media, mental health disorders, and tonsils disease were significantly more prevalent among pediatric patients. Children and adults were equally treated with ESS. Notably, children underwent additional surgery on adenoids and tonsils more frequently. The effectiveness of ESS in multimorbid adults should be assessed at an individual level.

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Section: Discussionsupporting

confidence: 47%

Comorbidities of chronic rhinosinusitis in children and adults

Murtomäki,

Helevä,

Torkki

et al. 2024

Clinical & Translational All

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“…33 Between 2012 and 2019 in Finland, the prevalence of CRSwNP rose from 602.2 to 856.7 patients per 100,000 people. 34 In this patient group, presence of severe asthma significantly increased the probability of receiving systemic corticosteroids and undergoing ESS. 34 A large hospital registry study in Finland 35 found that CRSwNP was associated with a disproportionate number of hospital visits (10/year, compared with 7 for asthma patients) despite comprising a relatively small proportion of the total number of diagnoses (7 patients at tertiary care per 100,000 inhabitants/year, vs 70 with asthma).…”

Section: Introductionmentioning

confidence: 82%

“…Taken together, these findings signal an urgent need for improved management of CRSwNP in Finland. 34 …”

Section: Introductionmentioning

confidence: 99%

Multi-Disciplinary Expert Perspective on the Management of Type 2 Inflammation-Driven Severe CRSwNP: A Brief Overview of Pathophysiology and Recent Clinical Insights

Toppila-Salmi,

Bjermer,

Cardell

et al. 2024

JAA

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Severe chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disabling airway disease that significantly impacts patients’ lives through the severity of symptoms, the need for long-term medical treatment and the high risk of recurrence post-surgery. Biological agents targeting type 2 immune responses underlying the pathogenesis of CRSwNP have shown effectiveness in reducing polyp size and eosinophilic infiltrate, and in decreasing the need for additional sinus surgeries. However, despite recent progress in understanding and treating the disease, type 2 inflammation-driven severe CRSwNP continues to pose challenges to clinical management due to several factors such as persistent inflammation, polyp recurrence, heterogeneity of disease, and comorbidities. This article presents the findings of a scientific discussion involving a panel of ear, nose and throat (ENT) specialists and pulmonologists across Sweden and Finland. The discussion aimed to explore current management practices for type 2 inflammation-driven severe CRSwNP in the Nordic region. The main topics examined encompassed screening and referral, measurements of disease control, treatment goals, and future perspectives. The experts emphasized the importance of a collaborative approach in the management of this challenging patient population. The discussion also revealed a need to broaden treatment options for patients with type 2 inflammation-driven CRSwNP and comorbid conditions with shared type 2 pathophysiology. In light of the supporting evidence, a shift in the disease model from the presence of polyps to that of type 2 inflammation may be warranted. Overall, this discussion provides valuable insights for the scientific community and can potentially guide the future management of CRSwNP.

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“…Chronic rhinosinusitis (CRS) affects 7% to 27% of adults in European countries, 14% in the United States, and 2.1% to 8% in China 1,2 . CRS with nasal polyps (CRSwNP) is a heterogeneous, multifactorial disease with frequent recurrences despite medical and surgical interventions 3 . The underlying mechanisms that contribute to the persistent inflammation of CRSwNP are not completely defined.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 CRS with nasal polyps (CRSwNP) is a heterogeneous, multifactorial disease with frequent recurrences despite medical and surgical interventions. 3 The underlying mechanisms that contribute to the persistent inflammation of CRSwNP are not completely defined.…”

Section: Introductionmentioning

confidence: 99%