Objective. This study compared three severity measures for chronic rhinosinusitis with nasal polyps (CRSwNP). The outcome was to identify patients who are eligible for biological therapy. Methods. 330 adult patients with CRSwNP were examined. Nasal polyp score (NPS), sinonasal outcome test (SNOT-22) and clinical-cytological grading (CCG) were compared. Clinical history, past surgery and asthma control test were also considered. Results. Only 45 (13.6%) patients had a contextual positivity to the three severity measures. The concordance among tests was slight/fair. Patients with severe disease (all tests positive) had more impaired parameters. The mixed cytotype (OR = 4.07), nasal obstruction (OR = 10.06), post-nasal drip (OR = 1.98), embarrassment (OR = 2.53) and difficulty falling asleep (OR = 1.92) were significantly associated with severe CRSwNP. Conclusions. To identify candidates for biological therapy, the contextual use of NPS, SNOT-22 and CCG is preferable. In this way, global assessment of CRSwNP, including morphology, inflammation, comorbidity, symptoms and quality of life is possible.
Obiettivo. Questo studio confrontava 3 differenti indici di gravità della rinosinusite cronica con poliposi nasale (RSCcPN). L’obbiettivo era individuare i pazienti eleggibili al trattamento con farmaci biologici. Metodi. 330 pazienti adulti con RSCcPN erano arruolati. Tutti i pazienti venivano valutati mediante nasal polyp score (NPS), sinonasal outcome test (SNOT-22) e clinical-cytological grading (CCG). Inoltre erano considerati la storia clinica, i pregressi interventi chirurgici ed il controllo dell’asma. Risultati. Solamente 45 (13,6%) pazienti avevano i 3 indici positivi. La concordanza tra i 3 indici era bassa/modesta. I pazienti con la malattia grave (contestuale positività a tutti i test) avevano peggiori parametri. Il citotipo misto (OR = 4,07), l’ostruzione nasale (OR = 10,06), il post-nasal drip (OR = 1,98), il disagio (OR = 2,53), e la difficoltà ad addormentarsi (OR = 1,92) erano significativamente associati con la malattia grave. Conclusioni. È preferibile utilizzare contemporaneamente i 3 test per individuare i pazienti candidati alla terapia biologica. In questo modo si può avere un quadro generale della malattia, comprendente la morfologia dei polipi, lo stato di infiammazione, le comorbidità, i sintomi e la qualità della vita.
Chronic rhinosinusitis with nasal polyps: how to identify eligible patients for biologics in clinical practice / M., Gelardi; C., Bocciolini; M., Notargiacomo; I., Schiavetti; C., Lingua; P., Pecoraro; L., Iannuzzi; V. A., Quaranta; R., Giancaspro; G., Ronca; M., Cassano; G., Ciprandi; Amorosa, Luca; Arnone, Flavio; Luperto, Paolo; Irene Sciancalepore, Pasqua; Alonzi, Luigi; Tomaiuolo, Marilena; Maselli Del Giudice, Alessandro; Miglietta, Anna; Seccia, Veronica; Giulio Sulis, Giovanni; Caruso, Cristiano; Rossi, Valentina; Ciofalo, Andrea; Calogera, Consagra; Palma, Antonio; Mancini, Michela. - In: ACTA OTORHINOLARYNGOLOGICA ITALICA. - ISSN 0392-100X. - 42:1(2022), pp. 75-81. [10.14639/0392-100X-N1699]
Chronic rhinosinusitis with nasal polyps: how to identify eligible patients for biologics in clinical practice
Andrea CiofaloInvestigation
;
2022
Abstract
Objective. This study compared three severity measures for chronic rhinosinusitis with nasal polyps (CRSwNP). The outcome was to identify patients who are eligible for biological therapy. Methods. 330 adult patients with CRSwNP were examined. Nasal polyp score (NPS), sinonasal outcome test (SNOT-22) and clinical-cytological grading (CCG) were compared. Clinical history, past surgery and asthma control test were also considered. Results. Only 45 (13.6%) patients had a contextual positivity to the three severity measures. The concordance among tests was slight/fair. Patients with severe disease (all tests positive) had more impaired parameters. The mixed cytotype (OR = 4.07), nasal obstruction (OR = 10.06), post-nasal drip (OR = 1.98), embarrassment (OR = 2.53) and difficulty falling asleep (OR = 1.92) were significantly associated with severe CRSwNP. Conclusions. To identify candidates for biological therapy, the contextual use of NPS, SNOT-22 and CCG is preferable. In this way, global assessment of CRSwNP, including morphology, inflammation, comorbidity, symptoms and quality of life is possible.| File | Dimensione | Formato | |
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