Associations between Fatigue and Medication Use in Chronic Rhinosinusitis

Background The aim of this study was to delineate patient symptoms and economic burdens of chronic rhinosinusitis (CRS). Methods Adult patients with CRS were assessed prospectively with a survey instrument. Symptom scores for major and minor symptoms of CRS, medication use, physician visits for CRS, and work days missed were determined. Cost analyses were conducted. Results Three hundred twenty-two patients were studied prospectively (mean age, 42.3 years). Nasal obstruction and facial congestion were the most common and severe major symptoms, and headache and fatigue were the most common and severe minor symptoms. Patients received an average of 2.7 antibiotic courses and used nasal steroids and prescription antihistamines 18.3 and 16.3 weeks, respectively, in a 12-month period. Mean medical resource costs were $921 per patient-year. CRS caused an average of 4.8 days of missed work per 12-month period. The overall yearly economic cost of CRS was $1539 per patient. Conclusion Nasal and facial symptoms prevail over systemic and oropharyngeal symptoms in CRS. Significant medical resource expenditures and global economic costs accompany CRS.

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Medication use in patients with chronic rhinosinusitis in Germany - a large retrospective patient-based study

Rhinology Journal ◽

10.4193/rhin18.055 ◽

2018 ◽

Cited By ~ 1

Author(s):

J.J.H. Park ◽

D.U. Seidel ◽

C. Bachert ◽

S. Dazert ◽

K. Kostev

Keyword(s):

Chronic Rhinosinusitis ◽

Medication Use

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Efficacy of Adenoidectomy for the Management of Chronic Rhinosinusitis in Children Older Than 7 Years of Age

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211045270 ◽

2021 ◽

pp. 000348942110452

Author(s):

Chengetai Mahomva ◽

Samantha Anne ◽

Christopher Roxbury

Keyword(s):

Chronic Rhinosinusitis ◽

Facial Pain ◽

Symptom Control ◽

Medication Use ◽

Retrospective Chart Review ◽

Older Children ◽

Patients Âgés ◽

Additional Surgery ◽

Nasal Steroids ◽

Symptom Persistence

Objectives: While adenoidectomy is the first-line surgical management of chronic rhinosinusitis (CRS) in young children, evidence regarding its utility in older children is lacking. This study aimed to assess the efficacy of adenoidectomy in children 7 to 18 years old with regard to symptom control, postoperative medication use, and the need for additional surgery. Methods: Single-institution retrospective chart review of patients ages 7 to 18 undergoing adenoidectomy for CRS from 2009 to 2019. Patients with cystic fibrosis and ciliary disorders were excluded. Comorbidities, preoperative and postoperative symptoms (rhinorrhea, congestion, anosmia, and facial pain), medication use (antibiotics, antihistamines, nasal steroids, and irrigations), and Lund-Mackay scores were extracted. McNemar’s or Wilcoxon Rank Sum Tests were used to assess rates of symptom control and medication use. Fisher’s exact or Chi-square tests were used to assess for factors associated with symptom persistence. Results: Ninety-seven patients with a mean age of 9 years (range 7-18) were identified. Patients were shown to experience significantly decreased rates of rhinorrhea (64.9% vs 20.6%, <.001), congestion (95.9% vs 26.8%, <.001), facial pain (17.5% vs 3.1%, .001), use of nasal steroids (79.4% vs 36.1%, <.001), antihistamines (47.4% vs 20.6%, <.001), and number of antibiotics (median 1 vs 0, <.001) after adenoidectomy. No patient or disease factors were associated with symptom persistence. Nine patients (9.3%) required additional nasal surgery. Conclusion: In this cohort of older children with CRS with limited follow up, additional surgery is not routinely done following adenoidectomy, the results suggest that adenoidectomy alone may provide adequate symptom control and medication reduction.

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Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis

Allergy and Asthma Proceedings ◽

10.2500/aap.2021.42.210058 ◽

2021 ◽

Vol 42 (5) ◽

pp. 417-424

Author(s):

Gayatri B. Patel ◽

Elizabeth A. Kudlaty ◽

Amina Guo ◽

Chen Yeh ◽

Margaret S. Kim ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Therapeutic Option ◽

Medication Use ◽

Systemic Corticosteroids ◽

Acute Exacerbations ◽

Before And After ◽

The Impact ◽

Yearly Rate

Background: Acute exacerbations of chronic rhinosinusitis (AECRS) are associated with significant morbidity and decreased quality of life. There are sparse data assessing the real-world impact of biologics on AECRS. Objectives: We sought to determine the impact of type 2‐targeting biologics on the frequency of medication use for AECRS episodes. Methods: Antibiotic and/or systemic corticosteroid courses for AECRS were identified in a retrospective study from November 2015 to February 2020, at a single academic health system. The estimated yearly rates for antibiotic and corticosteroid courses were evaluated before and after initiation of type 2 biologics. Results: One-hundred and sixty-five patients with chronic rhinosinusitis (CRS) had received either omalizumab (n = 12), mepolizumab (n = 42), benralizumab (n = 44), dupilumab (n = 61), or reslizumab (n = 6). Seventy percent had CRS with nasal polyps, and 30% had CRS without nasal polyps. All the patients had asthma. When all the biologics were combined, the estimated yearly rate for antibiotics for AECRS decreased from 1.34 (95% confidence interval [CI], 1.12‐1.59) to 0.68 (95% CI, 0.52‐0.88) with biologic use (49% reduction, p < 0.001). Those with frequent AECRS (three or more courses of antibiotics in the 1 year before biologic use) had a larger degree of reduction, with an estimated yearly rate of 4.15 (95% CI, 3.79‐4.55) to 1.58 (95% CI, 1.06‐2.35) with biologic use (n = 27; 62% reduction; p < 0.001). Within the total cohort, the estimated yearly rate for systemic corticosteroids for AECRS decreased from 1.69 (95% CI, 1.42‐2.02) to 0.68 (95% CI, 0.53‐0.88) with biologic use (60% reduction; p < 0.001). Conclusion: Type 2‐targeting biologics reduced medication use for AECRS. This suggested that biologics may be a therapeutic option for patients with frequent AECRS.

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