Asthma, Rhinitis, and Nasal Polyp Multimorbidities

Vizuete, José Antonio Castillo; Sastre, Joaquı́n; Bernal, Alfonso del Cuvillo; Picado, César; Moragón, Eva Martínez; García, José María Ignacio; Serrano, Carolina Cisneros; Gutiérrez, Francisco Javier Álvarez; Miret, Joaquim Mullol i

doi:10.1016/j.arbr.2018.12.020

Cited by 18 publications

(13 citation statements)

References 46 publications

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“…In our study, most CRSwNP patients were aged between forty and fty years with a male dominance. Patients with eCRSwNP had a familiar history of asthma, and the ndings are consistent with those in many previous studies (18)(19)(20).…”

Section: Discussionsupporting

confidence: 89%

Olfactory Disorder is The Specific Symptom to Distinguish Eosinophilic From Non-Eosinophilic Nasal Polyps

Pan

Zhang

Zhang³

2020

Preprint

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Background: Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) have poorer outcomes after endoscopic sinus surgery and a higher recurrence rate. This study aimed to investigate the profile of clinical symptoms of eCRSwNP and the related risk factors.Methods: We prospectively enrolled 298 CRSwNP inpatients from February 2019 to December 2019. Patients were divided into eCRSwNP and non-eCRSwNP groups based on the percentage of blood eosinophils. Clinical data on questionnaires, visual analogue scale (VAS) scores, and laboratory tests were collected. The differences in clinical symptoms, including nasal congestion, rhinorrhea, olfactory disorders, and head/facial pain, between the two groups were analyzed to identify the influential factors. Logistic analysis and receiver operating characteristic curves were used to determine the diagnostic benefit for the specific symptom in eCRSwNP patients.Results: Of the four major clinical symptoms, nasal congestion and olfactory disorders were significantly different between eCRSwNP and non-eCRSwNP groups. Patients with eCRSwNP more frequently complained about olfactory disorders (P = 0.002), while patients with non-eCRSwNP mostly had nasal congestion (P = 0.001). The logistic analysis showed that the primary risk factors for olfactory disorders of eCRSwNP were disease duration (P = 0.014) and alcohol intake (P = 0.012). Olfactory disorders were not associated with the disease course of eCRSwNP but were correlated with the disease duration of non-eCRSwNP (P = 0.008). When the clinical duration was less than 10 years, there was a significant difference in olfactory disorders between eCRSwNP and non-eCRSwNP groups (P < 0.01). However, when the clinical duration was over 10 years, the difference was not statistically significant (P = 0.264). The VAS score of olfactory disorders of over 5.75 could be used to predict the diagnosis of eCRSwNP (area under the curve ＝0.674, 95% confidence intervals: 0.559–0.689, P = 0.000). Conclusions: Olfactory disorder was the major nasal symptom that could be used to distinguish eCRSwNP and non-eCRSwNP. ECRSwNP patients were more prone to have olfactory dysfunction. Our findings suggest that evaluation of nasal symptoms will help diagnose eCRSwNP and determine subsequent clinical treatment strategies.

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Section: Discussionsupporting

confidence: 89%

Olfactory Disorder is The Specific Symptom to Distinguish Eosinophilic From Non-Eosinophilic Nasal Polyps

Pan

Zhang

Zhang³

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In our study, most CRSwNP patients were aged between forty and fty years with a male dominance. Patients with eCRSwNP had a familiar history of asthma, and the ndings were consistent with those in many previous studies (18)(19)(20).…”

Section: Discussionsupporting

confidence: 89%

Olfactory Disorder is the Specific Symptom to Distinguish Eosinophilic from non-eosinophilic Nasal Polyps

Pan

Zhang

2020

Preprint

View full text Add to dashboard Cite

Background: Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) have poorer outcomes after endoscopic sinus surgery and a higher recurrence rate. This study aimed to investigate the profile of clinical symptoms of eCRSwNP and the related risk factors.Methods: We prospectively enrolled 298 CRSwNP inpatients from February 2019 to December 2019. Patients were divided into eCRSwNP and non-eCRSwNP groups based on the percentage of blood eosinophils. Clinical data on questionnaires, visual analogue scale (VAS) scores, and laboratory tests were collected. The differences in clinical symptoms, including nasal congestion, rhinorrhea, olfactory disorders, and head/facial pain, between the two groups were analyzed to identify the influential factors. Logistic analysis and receiver operating characteristic curves were used to determine the diagnostic benefit for the specific symptom in eCRSwNP patients.Results: Of the four major clinical symptoms, nasal congestion and olfactory disorders were significantly different between eCRSwNP and non-eCRSwNP groups. Patients with eCRSwNP more frequently complained about olfactory disorders (P = 0.002), while patients with non-eCRSwNP mostly had nasal congestion (P = 0.001). The logistic analysis showed that the primary risk factors for olfactory disorders of eCRSwNP were disease duration (P = 0.014) and alcohol intake (P = 0.012). Olfactory disorders were not associated with the disease course of eCRSwNP but were correlated with the disease duration of non-eCRSwNP (P = 0.008). When the clinical duration was less than 10 years, there was a significant difference in olfactory disorders between eCRSwNP and non-eCRSwNP groups (P < 0.01). However, when the clinical duration was over 10 years, the difference was not statistically significant (P = 0.264). The VAS score of olfactory disorders of over 5.75 could be used to predict the diagnosis of eCRSwNP (area under the curve ＝0.674, 95% confidence intervals: 0.559–0.689, P = 0.000). Conclusions: Olfactory disorder was the major nasal symptom that could be used to distinguish eCRSwNP and non-eCRSwNP. ECRSwNP patients were more prone to have olfactory dysfunction. Our findings suggested that evaluation of nasal symptoms would help diagnose eCRSwNP and determine subsequent clinical treatment strategies.

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“…22 Furthermore, nasal polyposis is not only a frequent comorbidity in severe asthmatic patients, but it seems to be associated with a phenotype in which patients are more severe than those who are not affected by this comorbidity. 23 A large proportion of the severe asthma patients enrolled in the SANI registry fulfilled the ATS/ERS and GINA definitions. This could be expected for 2 reasons.…”

Section: Discussionmentioning

confidence: 99%

Severe asthma: One disease and multiple definitions

Bagnasco

Paggiaro

Latorre

et al. 2021

World Allergy Organization Journal

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Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

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Asthma, Rhinitis, and Nasal Polyp Multimorbidities

Cited by 18 publications

References 46 publications

Olfactory Disorder is The Specific Symptom to Distinguish Eosinophilic From Non-Eosinophilic Nasal Polyps

Olfactory Disorder is The Specific Symptom to Distinguish Eosinophilic From Non-Eosinophilic Nasal Polyps

Olfactory Disorder is the Specific Symptom to Distinguish Eosinophilic from non-eosinophilic Nasal Polyps

Severe asthma: One disease and multiple definitions

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