Patients with severe asthma and with vs without chronic rhinosinusitis with nasal polyposis (CRSwNP) were found to have more asthma exacerbations and to be more likely to have long-term oral corticosteroid use, according to a study published in Respiratory Medicine.

In this study, the data of 695 patients with severe asthma (mean age, 54.9±16.6 years) who were included in the Severe Asthma Network Italy registry were examined. Demographic data and information on clinical features, asthma control in the preceding month (based on Global INitiative for Asthma guidelines and standardized questionnaires), concomitant regular and on-demand treatments, and inflammatory markers, were collected.

In this cohort, 40.6% of patients had CRSwNP. Mean age, sex distribution, mean age at asthma onset, atopy, and mean body mass index were comparable in patients with vs without CRSwNP. Patients with vs without CRSwNP had a greater prevalence of atopic dermatitis (8.6% vs 3.4%, respectively; P =.019) and bronchiectasis (20.9% vs 11.9%, respectively; P =.001).

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Patients with vs without CRSwNP had greater mean fractional exhaled nitric oxide (54.5±53.8 ppb vs 34.6±28.3 ppb, respectively; P <.0001), higher mean annual asthma exacerbation rate (3.69±7.43 vs 2.46±3.00, respectively; P =.014), a greater number of days on oral corticosteroids per year (161.4 vs 78.9; P =.02), and a greater percentage of patients with vs without CRSwNP were long-term oral corticosteroid users (60.6% vs 37.3%, respectively; P <.001).

Study limitations include its retrospective design and the sole inclusion of patients from Italy.

“The use of [oral corticosteroids] in patients with [severe asthma] and CRSwNP, being effective on both disorders, would be of great value both for the patient viewpoint and for the sustainability of these costly treatments,” concluded the study authors.

Reference

Canonica GW, Malvezzi L, Blasi F, et al; Severe Asthma Network Italy (SANI). Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry. Respir Med. 2020;166:105947.