Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma
Background: Respiratory multimorbidities are linked to asthma, such as allergic rhinitis (AR) with early allergic asthma and chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) with late nonallergic asthma. Objective: Our aim was to investigate the association of asthma severity and control with...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-11-01
|
| Series: | Journal of Allergy and Clinical Immunology: Global |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772829323000590 |
| _version_ | 1797632603180761088 |
|---|---|
| author | José Antonio Castillo, MD, PhD Vicente Plaza, MD, PhD Gustavo Rodrigo, MD, PhD Berta Juliá, MD, PhD César Picado, MD, PhD Cristina Fernández, MD, PhD Joaquim Mullol, MD, PhD, FAAAAI |
| author_facet | José Antonio Castillo, MD, PhD Vicente Plaza, MD, PhD Gustavo Rodrigo, MD, PhD Berta Juliá, MD, PhD César Picado, MD, PhD Cristina Fernández, MD, PhD Joaquim Mullol, MD, PhD, FAAAAI |
| author_sort | José Antonio Castillo, MD, PhD |
| collection | DOAJ |
| description | Background: Respiratory multimorbidities are linked to asthma, such as allergic rhinitis (AR) with early allergic asthma and chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) with late nonallergic asthma. Objective: Our aim was to investigate the association of asthma severity and control with specific upper airway phenotypes. Method: Patients with asthma were prospectively recruited from 23 pulmonology and ear, nose, and throat clinics. Asthma severity and control, as well as upper airway comorbidities (AR and non-AR [NAR], CRSwNP, and CRS without nasal polyps [CRSsNP]) were assessed according to international consensus guidelines definitions. Results: A total of 492 asthmatic patients were included. Half of the asthmatic patients (49.6%) had associated rhinitis (37.0% had AR and 12.6% had NAR) and 36.2% had CRS (16.7% had CRSsNP and 19.5% had CRSwNP), whereas 14.2% had no sinonasal symptoms. Most cases of AR (78%) and NAR (84%) were present in patients with mild-to-moderate asthma, whereas CRSwNP was more frequent in patients with severe asthma (35% [P < .001]), mainly nonatopic asthma (44% [P < .001]). Patients with severe asthma with CRSwNP had worse asthma control, which was correlated (r = 0.249 [P = .034]) with sinus occupancy. Multiple logistic regression analysis showed that late-onset asthma, intolerance of aspirin and/or nonsteroidal anti-inflammatory drugs, and CRSwNP were independently associated with severe asthma. Conclusion: Severe asthma is associated with CRSwNP, with sinus occupancy affecting asthma control. This study has identified 2 main different upper airway treatable traits, AR and CRSwNP, which need further evaluation to improve management and control of patients with asthma. |
| first_indexed | 2024-03-11T11:40:09Z |
| format | Article |
| id | doaj.art-05e8db320de540efb8836a312332c5b9 |
| institution | Directory Open Access Journal |
| issn | 2772-8293 |
| language | English |
| last_indexed | 2024-03-11T11:40:09Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Allergy and Clinical Immunology: Global |
| spelling | doaj.art-05e8db320de540efb8836a312332c5b92023-11-10T04:16:50ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932023-11-0124100134Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthmaJosé Antonio Castillo, MD, PhD0Vicente Plaza, MD, PhD1Gustavo Rodrigo, MD, PhD2Berta Juliá, MD, PhD3César Picado, MD, PhD4Cristina Fernández, MD, PhD5Joaquim Mullol, MD, PhD, FAAAAI6Pneumology Department, Hospital Universitari Dexeus, Barcelona, Spain; CIBER of Respiratory Diseases, Spain; Group of Rhinitis, Rhinosinusitis, and Nasal Polyps, Area of Asthma, SEPAR, Spain; Corresponding author: José Antonio Castillo, MD, PhD, Sant Joan 10, 08870 Sitges, Barcelona, Spain.Pneumology Department, Hospital Santa Creu i Sant Pau, Barcelona, SpainEmergency Departament, Hospital Central de las Fuerzas Armadas, Montevideo, UruguayMedical Department, MSD Madrid, SpainCIBER of Respiratory Diseases, Spain; Pneumology Department, Hospital Clinic, Universitat de Barcelona, Barcelona, SpainPreventive Medicine Department, Complejo Hospitalario Universitario de Santiago de Compostela, Instituto de Investigación Sanitaria Santiago de Compostela, Fundación IMAS, Santiago de Compostela, SpainCIBER of Respiratory Diseases, Spain; Group of Rhinitis, Rhinosinusitis, and Nasal Polyps, Area of Asthma, SEPAR, Spain; Clinical and Experimental Respiratory Immunoallergy, IDIBAPS & Rhinology Unite and Smell Clinic, ENT Department, Hospital Clínic Barcelona, Universitat de Barcelona, Spain; Joaquim Mullol, MD, PhD, FAAAAI, Entença 64, 3° 1a, 08015 Barcelona, Spain.Background: Respiratory multimorbidities are linked to asthma, such as allergic rhinitis (AR) with early allergic asthma and chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) with late nonallergic asthma. Objective: Our aim was to investigate the association of asthma severity and control with specific upper airway phenotypes. Method: Patients with asthma were prospectively recruited from 23 pulmonology and ear, nose, and throat clinics. Asthma severity and control, as well as upper airway comorbidities (AR and non-AR [NAR], CRSwNP, and CRS without nasal polyps [CRSsNP]) were assessed according to international consensus guidelines definitions. Results: A total of 492 asthmatic patients were included. Half of the asthmatic patients (49.6%) had associated rhinitis (37.0% had AR and 12.6% had NAR) and 36.2% had CRS (16.7% had CRSsNP and 19.5% had CRSwNP), whereas 14.2% had no sinonasal symptoms. Most cases of AR (78%) and NAR (84%) were present in patients with mild-to-moderate asthma, whereas CRSwNP was more frequent in patients with severe asthma (35% [P < .001]), mainly nonatopic asthma (44% [P < .001]). Patients with severe asthma with CRSwNP had worse asthma control, which was correlated (r = 0.249 [P = .034]) with sinus occupancy. Multiple logistic regression analysis showed that late-onset asthma, intolerance of aspirin and/or nonsteroidal anti-inflammatory drugs, and CRSwNP were independently associated with severe asthma. Conclusion: Severe asthma is associated with CRSwNP, with sinus occupancy affecting asthma control. This study has identified 2 main different upper airway treatable traits, AR and CRSwNP, which need further evaluation to improve management and control of patients with asthma.http://www.sciencedirect.com/science/article/pii/S2772829323000590Asthmaallergic rhinitischronic rhinosinusitis with nasal polypsunited airway diseaseasthma severityasthma control |
| spellingShingle | José Antonio Castillo, MD, PhD Vicente Plaza, MD, PhD Gustavo Rodrigo, MD, PhD Berta Juliá, MD, PhD César Picado, MD, PhD Cristina Fernández, MD, PhD Joaquim Mullol, MD, PhD, FAAAAI Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma Journal of Allergy and Clinical Immunology: Global Asthma allergic rhinitis chronic rhinosinusitis with nasal polyps united airway disease asthma severity asthma control |
| title | Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma |
| title_full | Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma |
| title_fullStr | Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma |
| title_full_unstemmed | Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma |
| title_short | Chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma |
| title_sort | chronic rhinosinusitis with nasal polyps and allergic rhinitis as different multimorbid treatable traits in asthma |
| topic | Asthma allergic rhinitis chronic rhinosinusitis with nasal polyps united airway disease asthma severity asthma control |
| url | http://www.sciencedirect.com/science/article/pii/S2772829323000590 |
| work_keys_str_mv | AT joseantoniocastillomdphd chronicrhinosinusitiswithnasalpolypsandallergicrhinitisasdifferentmultimorbidtreatabletraitsinasthma AT vicenteplazamdphd chronicrhinosinusitiswithnasalpolypsandallergicrhinitisasdifferentmultimorbidtreatabletraitsinasthma AT gustavorodrigomdphd chronicrhinosinusitiswithnasalpolypsandallergicrhinitisasdifferentmultimorbidtreatabletraitsinasthma AT bertajuliamdphd chronicrhinosinusitiswithnasalpolypsandallergicrhinitisasdifferentmultimorbidtreatabletraitsinasthma AT cesarpicadomdphd chronicrhinosinusitiswithnasalpolypsandallergicrhinitisasdifferentmultimorbidtreatabletraitsinasthma AT cristinafernandezmdphd chronicrhinosinusitiswithnasalpolypsandallergicrhinitisasdifferentmultimorbidtreatabletraitsinasthma AT joaquimmullolmdphdfaaaai chronicrhinosinusitiswithnasalpolypsandallergicrhinitisasdifferentmultimorbidtreatabletraitsinasthma |