The GALEN rhinosinusitis cohort: chronic rhinosinusitis with nasal polyps affects health-related quality of life

Abstract

Background: Chronic rhinosinusitis (CRS) significantly affects health-related quality of life (HRQoL). Few multinational observational studies have evaluated the impact of CRS with nasal polyps (CRSwNP) on patients' HRQoL. This study aimed to assess HRQoL outcomes (including analyses by disease severity and impact of comorbidities and refractory disease) in CRSwNP patients from a large European database. Methodology: Data were analysed from the Global Allergy and Asthma European Network (GALEN) Rhinosinusitis Cohort, including sociodemographic data, patient-reported disease severity (visual analogue scale), and scores on the 36-Item Short-Form Health Survey (SF-36) questionnaire. Differences in mean SF-36 scores were evaluated between patients with CRSwNP and population norms and between subgroups of interest (disease severity, comorbidity, and refractory disease, defined by a history of sinonasal surgery). Results: Patients with CRSwNP (N = 445) had significantly lower mean SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores vs population norms, demonstrating that CRSwNP negatively affects HRQoL. The presence of comorbidities affected HRQoL, as shown by significant differences in PCS scores in patients with asthma or non-steroidal antiinflammatory drug-exacerbated respiratory disease, compared with patients without asthma. Patients with moderate-to-severe disease had significantly lower PCS scores than patients with mild disease. Severe disease had a significant impact on MCS score. History of surgery had a clinically meaningful negative effect on HRQoL compared with no history of surgery. Conclusions: CRSwNP patients have significantly lower HRQoL compared with population norms. The impact is greater in patients with greater disease severity, comorbidities, or refractory disease.

Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials

“…2 A recent large single-center study from the United States reported that approximately 18% of patients with CRS have CRSwNP. 3 CRSwNP is associated with adult-onset asthma, significant morbidity, decreased health-related quality of life (HRQoL), [4][5][6][7][8] and substantial economic burden (amounting to more than $22 billion for CRS in the United States in 2014). 9,10 Quality of life (QoL) impairment is comparable with that experienced by patients with chronic lower back pain.…”

Burden of Disease in Chronic Rhinosinusitis with Nasal Polyps

“…1,26,31 NSAID-ERD in particular is thought to place an especially high clinical burden on affected patients. 9,34 The frequent recurrence of nasal polyps after surgery and a requirement for high-dose SCS to manage asthma, if present, reflect the persistent and aggressive nature of the disease. 42 In the USA, it is estimated that patients with CRSwNP with NSAID-ERD undergo an average of three sinus operations during their lifetime.…”

“…The disease burden with significantly lower physical and mental HRQoL than population norms is particularly high in CRSwNP. This is particularly in patients with comorbid asthma and/or NSAID-ERD 9 and in patients who need repeated treatment with corticosteroids and/or sinonasal surgeries to alleviate its uncontrolled symptoms. The impact on HRQoL is comparable with other chronic diseases such as chronic obstructive pulmonary disease (COPD), asthma, and diabetes.…”

Chronic Rhinosinusitis Patients With and Without Polyps Experience Different Symptom Perception and Quality of Life Burdens

“…14,15 Despite welldescribed differences between CRSwNP and CRSsNP, understanding the distinction between these 2 populations of CRS patients remains a timely and active area of investigation with therapeutic implications. 16,17 Patient perception of the CRS disease process is an increasingly recognized as an important modulator of the CRS disease course, affecting tolerance of symptoms and QOL impact felt by patients. [18][19][20][21][22] Patient perception of disease has not yet been well distinguished between CRSwNP and CRSsNP.…”

“…14 , 15 Despite well-described differences between CRSwNP and CRSsNP, understanding the distinction between these 2 populations of CRS patients remains a timely and active area of investigation with therapeutic implications. 16 , 17…”