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

Autor: Toppila-Salmi S; Department of Allergology Department of Pulmonary Medicine, Heart and Lung Center Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland., Hällfors J; Medaffcon Oy Espoo Finland., Aakko J; Medaffcon Oy Espoo Finland., Mannerström B; Medaffcon Oy Espoo Finland., Nieminen K; AstraZeneca Nordic Espoo Finland., Telg G; AstraZeneca Nordic Södertälje Sweden., Lehtimäki L; Faculty of Medicine and Health Technology Tampere University Respiratory Research Group Tampere University Tampere Finland.; Allergy Centre Tampere University Hospital Tampere Finland.
Jazyk: angličtina
Zdroj: Clinical and translational allergy [Clin Transl Allergy] 2022 Oct 09; Vol. 12 (10), pp. e12200. Date of Electronic Publication: 2022 Oct 09 (Print Publication: 2022).
DOI: 10.1002/clt2.12200
Abstrakt: Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is commonly associated with asthma. Treatment of CRSwNP includes intranasal and systemic corticosteroids, with non-responsive patients commonly considered for endoscopic sinus surgery (ESS). This nationwide register-based study evaluated the incidence, prevalence, and treatment burden of CRSwNP in Finland, and their association with the presence and severity of comorbid asthma.
Methods: Electronic health records of patients diagnosed with CRSwNP between 1.1.2012 and 31.12.2018 in Finnish specialty and primary care were included in the study. The patients were divided into subgroups based on presence, severity, and control of asthma: no asthma, mild to moderate asthma, severe controlled asthma, and severe uncontrolled asthma. A mean cumulative count of ESS was calculated over time per subgroup.
Results: The prevalence of CRSwNP increased from 602.2 to 856.7 patients per 100,000 population between years 2012 and 2019 ( p  < 0.001). A total of 18,563 patients (59.9% male) had incident CRSwNP between 2012 and 2019, with 27% having asthma, 6% having severe asthma, and 1.5% having severe uncontrolled asthma. In the no asthma, severe controlled asthma, and severe uncontrolled asthma subgroups, systemic corticosteroids were used by 54.1%, 94.9% and 99.3% ( p  < 0.001), respectively, while the ESS count 3 years post diagnosis was 0.49, 0.68 and 0.80, respectively.
Conclusions: The prevalence of CRSwNP showed a significant increase in the recent decade in Finland. Comorbid asthma, and in particular severe asthma, increased the probability of receiving systemic corticosteroids and undergoing ESS. Thus, improved management of CRSwNP in patients with comorbid asthma is urgently needed.
Competing Interests: Sanna Toppila‐Salmi reports a grant of GSK and consultancies for ALK Abello, AstraZeneca, ERT, Novartis, Sanofi Pharma, and Roche. All these are outside the submitted work. Lauri Lehtimäki has received fees for lectures or advisory board meetings from ALK, AstraZeneca, Boehringer‐Ingelheim, Chiesi, Circassia, GSK, Mundipharma, Novartis, Orion Pharma and Sanofi. Lauri Lehtimäki owns shares of Ausculthing Oy. Gunilla Telg and Kaisa Nieminen are employees of AstraZeneca. The remaining authors has no conflicts to declare.
(© 2022 The Authors. Clinical and Translational Allergy published by John Wiley and Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje