Deterioration of mental and physical QOL from CRSwNP vs general population

In terms of physical and mental health, deterioration in health-related quality of life (HRQOL) was seen in critically ill patients Chronic sinusitis with nasal polyps (CRSwNP), according to new data published at Journal of Asthma and Allergy.

The outcome of these patients was SINUS-24 studyAssessments were conducted using a 36-item Short Form (SF-36) questionnaire and the EuroQol-5 Dimension Visual Analogue Scale (EQ VAS). The population standard scores used were 50 and 70.4 to 83.3, respectively.

Among the 276 patients included in the intent-to-treat analysis, analyzes were performed between overall results and patient subgroups: presence or absence of previous nasal polyp (NP) surgery, prior systemic corticosteroids ( SCS) use (within the past 2 years) and prior surgery or prior SCS use and no prior NP surgery, coexisting asthma, coexisting nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NSAID-ERD) ) and presence or absence of olfactory impairment.

“CRSwNP is primarily a type 2 inflammatory disease with a high symptom burden,” the researchers wrote. “However, data on the comparative health status of patients with CRSwNP are lacking.”

Overall, 76% of patients were anosmia. 71.7% had a history of sinus surgery. 58.3% had asthma. 38.4% had a history of sinus surgery and SCS. and 30.4%, coexisting NSAID-ERD. Their mean (SD) age was 50.5 (13.4) years, 42.8% were female patients, and the mean age since NP diagnosis was 11.1 (9.2) years.

The SF-36 mental component summary (MCS) and physical component summary (PCS) scores were 46.4 and 48.6, respectively, lower than the population criterion of 50. Mean EQ-VAS scores were also lower than published values. A typical range of 70.4 to 83.3 gives 66.0.

Patient populations with CRSwNP were also compared to patients with rheumatoid arthritis, type 2 diabetes (T2D), and asthma. T2D and asthma scores were similar overall, while rheumatoid arthritis had a lower score of 32.5.

Analyzes performed specifically among patient subgroups found the following results:

• Patients with CRSwNP and comorbid asthma (n = 161) had lower scores of 44.5 and 48.1 on the SF-36 PCS and MCS, respectively, and the mean EQ-VAS for this group was 64.8, all lower than population criteria
• NSAID-ERD patients (n = 84) had lower SF-36 PCS, SF-36 MCS, and EQ-VAS scores of 44.4, 48.1, and 63.9, respectively, compared with participants with concomitant asthma.below population standards
• Individuals with anosmia (n = 208) had scores on PCS, MCS, and EQ-VAS similar to those with asthma: 45.4, 48.3, and 63.9.

Furthermore, SF-36 PCS and MCS were moderately and weakly correlated with EQ-VAS scores, respectively. Overall, the SF-36 score was weakly correlated with all objective measures of disease severity, including the nasal polyp score, Lund-Mackay CT, and the University of Pennsylvania Olfactory Discrimination Test. and 22-item Sino-Nasal Outcome Test total scores were moderately correlated with both SF-36 PCS and MCS.

Speaking about the significance of the findings, the study authors noted that their data add to those of previous studies on disorders of physical and mental HRQOL, and that the findings are for the global study population in which they are included. , emphasized the possibility of more generalization.

This decline in HRQOL is due to “the myriad symptoms associated with severe disease and its common complications, and the lack of recognition of the humanitarian and economic impact of living with such a disease on a daily basis.” could be attributed to,” they concluded.

This emphasizes the importance of analyzing HRQOL separately.

reference

Maspero JF, Khan AH, Philpott C, et al. Health-related quality of life decline in patients with severe chronic sinusitis with nasal polyps in the SINUS-24 trial. J Asthma Allergy2023; 16:323-332. doi:10.2147/JAA.S372598