Disease Severity Worse in Chronic Rhinosinusitis With vs Without Asthma

In a real-world study of patients with chronic rhinosinusitis (CRS) with and without comorbid asthma, a higher proportion of those with CRS and asthma were classified as Global Initiative for Asthma (GINA) steps 4 and 5, relative to what is expected in the general asthma population, which is indicative of a higher level of disease severity, according to study results presented at American College of Allergy, Asthma & Immunology (ACAAI) 2020 Annual Scientific Meeting, held virtually from November 13 to 15. Researchers conducted a retrospective analysis, based on patient claims data obtained from Symphony Health between October 2013 and October 2018.

Recognizing that patients with CRS with or without nasal polyps (CRSwNP/CRSsNP) may report lack of satisfaction with their current therapies because of suboptimal symptom control, investigators evaluated the treatment of patients with CRSwNP/CRSsNP with or without asthma via the use of real-world data. All patients aged 18 years or older who had 2 or more CRS claims on separate dates and 2 years of active enrollment prior to the index date were included in the analysis. Current asthma treatment recommendations from GINA 2019 were used to evaluate the distribution of patients with CRS and comorbid asthma.

In a sample of approximately 4.2 million patients, a total of 1,274,891 met the criteria for the analysis, with 18% and 82% of individuals comprising the CRSwNP group and the CRSsNP group, respectively. When GINA 2019 criteria were applied in participants who had comorbid asthma, 13%, 16%, 15%, 26%, and 30% of patients were classified as being GINA steps 1 2, 3, 4, and 5, respectively.

The percentage of patients in GINA steps 4 and 5 was higher in those in the CRSwNP group (37% and 30%, respectively) compared with those in the CRSsNP group (27% and 25%, respectively). Acute and chronic oral corticosteroids (OCS) were frequently prescribed in these individuals.

The researchers concluded that according to the findings from this analysis, additional treatments are needed to minimize the risks associated with the increased use of both acute and chronic OCS in this patient population.

Reference

Ortega H, Skolnick B, Nelson G, Chornak J, Chiddarwar H, Han J. Patients with chronic rhinosinusitis with and without asthma: real-world experience. Presented at: the American College of Allergy, Asthma & Immunology (ACAAI) 2020 Annual Scientific Meeting (Virtual Experience); November 13-15, 2020. Abstract D201.