A real-world assessment of asthma with chronic rhinosinusitis

A real-world assessment of asthma with chronic rhinosinusitis:



Publication date: Available online 30 March 2020

Source: Annals of Allergy, Asthma & Immunology

Author(s): Fabio Luigi Massimo Ricciardolo, Stefano Levra, Andrea Elio Sprio, Francesca Bertolini, Vitina Carriero, Fabio Gallo, Giorgio Ciprandi



A real-world assessment of asthma with chronic rhinosinusitis

Author links open overlay panelFabio Luigi MassimoRicciardoloMD, PhD, FERS∗StefanoLevraMD∗Andrea ElioSprioPhD†FrancescaBertoliniPhD†VitinaCarrieroPhD†FabioGalloPhD‡GiorgioCiprandiMD§

∗

Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga University Hospital, Turin, Italy

†

Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

‡

Department of Health Science, University of Genoa, Genoa, Italy

§

Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy

Received 13 January 2020, Revised 3 March 2020, Accepted 5 March 2020, Available online 30 March 2020.



Show less

https://doi.org/10.1016/j.anai.2020.03.004Get rights and content

Abstract

Background

Chronic rhinosinusitis (CRS) includes 2 main phenotypes: CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP). CRS has been reported to be a comorbidity of asthma.



Objective

This study aimed to investigate the role of CRS in outpatients with asthma visited in real-world setting.



Methods

This cross-sectional study enrolled 499 consecutive outpatients with asthma. Age, sex, body mass index, smoking status, lung function, Asthma Control Test, inflammatory type 2 biomarkers (including fractional exhaled nitric oxide, blood eosinophils, serum total immunoglobulin E, and allergy), treatment step according to the Global Initiative for Asthma, and comorbidities (obstructive sleep apnea syndrome, arterial hypertension, bronchiectasis, diabetes mellitus type 2, and osteoporosis) were evaluated.



Results

A total of 179 (35.87%) patients had CRS, in particular 93 (18.64%) had CRSsNP and 86 (17.23%) had CRSwNP. Type 2 inflammation (defined by at least 1 positive biomarker) was present in 81.44% of patients (fractional exhaled nitric oxide > 30 parts per billion in 46.9%, blood eosinophil count > 300 cell/μL in 39.67%, serum total immunoglobulin E >100 IU/mL in 51.54%, and allergy in 53.71%). By multivariate analysis, type 2 inflammation and blood eosinophils greater than 300 cell/μL were the main predictors (odds ratio [OR] 2.54 and 2.26, respectively) of CRS-asthma association. In particular, CRSwNP comorbidity was predicted by type 2 inflammation (OR 3.4) and blood eosinophils greater than 300 cell/μL (OR 3.0). Smoking had conflicting outcome.



Conclusion

This study confirmed that CRS is a frequent asthma comorbidity because it affects more than one-third of outpatients with asthma. CRSwNP is associated with type 2 inflammation and blood eosinophilia. These outcomes underline that CRSwNP asthma phenotype deserves adequate attention for careful management and optimal identification of the best-tailored therapy.



Disclosures: The authors have no conflicts of interest to report.



Funding Sources: The authors have no funding sources to report.



View full text

© 2020 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.