The Global Allergy and Asthma European Network (GALEN rhinosinusitis cohort: a large European cross-sectional study of chronic rhinosinusitis patients with and without nasal polyps

Abstract

Background: Chronic rhinosinusitis (CRS) is a common yet under-recognised chronic inflammatory disease of the nose and paranasal sinuses that is classified according to the presence (CRSwNP) or absence (CRSsNP) of nasal polyps.Methods: This paper reports the methodology and descriptive results of the Global Allergy and Asthma European Network (GALEN) rhinosinusitis cohort. We established a large CRS cohort within the GALEN consortium (European FP6 research initiative) to identify inflammatory endotypes, the natural disease course, and its impact on health-related quality of life (HRQoL). Detailed information on the impact of CRS on HRQoL, comorbidity incidence, objective disease measures, and medical and surgical treatments were collected.Results: This multicentre cross-sectional case-control study recruited 935 adults (869 eligible for analysis: 237 CRSsNP; 445CRSwNP; 187 controls [reference group]). Comorbidities such as asthma, allergy, eczema, food allergy, urticaria, and chronic obstructive pulmonary disease were significantly more frequent in CRS patients. Nasal corticosteroids, antibiotics, and oral corticosteroids were the most common treatments. Significantly more CRSwNP patients reported previous sinonasal surgery. Conclusions:This study provides detailed information that facilitates studying CRS and its main phenotypes. However, patient distribution of this study does not necessarily reflect disease distribution in the general population.

EUFOREA consensus on biologics for CRSwNP with or without asthma

“…In clinical practice, systemic corticosteroids are used more frequently and for longer periods than proposed in guidelines. 8,60 Real-life studies are needed to determine the cumulative exposure to corticosteroids of patients with comorbid CRSwNP and asthma. The side effects of repeated use of systemic corticosteroids were also identified by the patient advisory board as a major concern.…”

“…CRS is classically divided into a phenotype with and without nasal polyps (CRSwNP and CRSsNP, respectively). Using patient questionnaires to measure the prevalence of CRSwNP yielded estimates of 2.1% (France) to 4.3% (Finland) in Europe and 1.1% in China . CRSwNP comprises a heterogeneous group of patients who differ with respect to coexisting asthma, allergy, NSAID‐exacerbated respiratory disease (N‐ERD), smoking, age of onset, and disease severity .…”

“…Using patient questionnaires to measure the prevalence of CRSwNP yielded estimates of 2.1% (France) to 4.3% (Finland) in Europe and 1.1% in China. 8 CRSwNP comprises a heterogeneous group of patients who differ with respect to coexisting asthma, allergy, NSAID-exacerbated respiratory disease (N-ERD), 9 smoking, age of onset, and disease severity. [10][11][12] Asthma affects 30%-70% of the CRSwNP patients.…”

“…[10][11][12] Asthma affects 30%-70% of the CRSwNP patients. 8,10,13,14 Conversely, the presence of nasal polyps is associated with the severity of asthma, regardless of smoking status ranging from 10%-30% in mild asthma to 70%-90% in severe asthma. 15,16 Both CRSwNP and asthma share common underlying pathophysiological mechanisms driving the disease (endotype), of which type 2 inflammation is the most prominent.…”

The GALEN rhinosinusitis cohort: chronic rhinosinusitis with nasal polyps affects health-related quality of life

“…European countries and includes 2 European societies, 60 collaboration centres, 27 research institutes, and 2 small-to-mediumsized enterprises (defined as legally independent companies with ≤ 500 employees). The GALEN Rhinosinusitis Cohort, a component of the GALEN network, is a European cross-sectional cohort that was established to enhance and advance research on CRS (12,23,24) .…”