Chronic rhinosinusitis with nasal polyps: how to identify eligible patients for biologics in clinical practice.

Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale 2022 Feb

filter terms:

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. 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. 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. 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. Copyright © 2022 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.

Citation

Matteo Gelardi, Corso Bocciolini, Mario Notargiacomo, Irene Schiavetti, Cristiano Lingua, Pietro Pecoraro, Lucia Iannuzzi, Vitaliano Antonio Quaranta, Rossana Giancaspro, Gianluca Ronca, Michele Cassano, Giorgio Ciprandi, Italian Study Group on Nasal Polyps. Chronic rhinosinusitis with nasal polyps: how to identify eligible patients for biologics in clinical practice. Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale. 2022 Feb;42(1):75-81