A new study presented at the recent American Rhinologic Society, Combined Otolaryngology Spring Meeting (ARS-COSM) held in Boston, Massachusetts, May 3-5, compared the patterns, burden of oral corticosteroid and healthcare resource utilization (HCRU) in chronic rhinosinusitis with nasal polyps (CRSwNP) patients who received functional endoscopic sinus surgery (FESS).
Chronic Rhinosinusitis with nasal polyps is an inflammatory disease of the nasal cavity and paranasal sinuses, associated with high symptom burden and poor health-related quality of life (QoL). When there is inadequate medical management, functional endoscopic sinus surgery (FESS) may be prescribed. However, the burden of oral corticosteroid (OCS) may remain after the FESS treatment, indicating an unmet need.
The retrospective cohort study led researchers from Real World Evidence Sanofi included CRSwNP patients in Optum CDM SES claims database between Nov 2012 and Aug 2020. Patients with no diagnosis of CRSwNP, age less than 18 years, underwent biologic therapy previously, were diagnosed with sinus cancer in the past year, and those having FESS done before the study index date were excluded from the study.
A total of 43,751 CRSwNP patients who underwent FESS and those who didn’t were sampled through a risk-set using a 1:4 matching ratio followed by a 1:1 propensity score matched at baseline to adjust for confounding. The intervention period was Days 0-44, while the follow-up period was Days 45-365. In addition, the OCS burden was evaluated as cumulative OCS dose in mg prednisone equivalents per patient.
Study results showed that during the follow-up period, FESS patients, as compared to the non-FESS ones, exhibited a modestly lower average cumulative OCS dose of 40 mg per patient. Moreover, no significant difference in HCRU was observed between the groups in baseline or follow-up, except when frequent Otolaryngologist visits were during follow-up. In addition, medications for CRSwNP, except for inhaled corticosteroids, showed no significant difference between the FESS and non-FESS patients during follow-up. The researchers also observed that more FESS patients than non-FESS ones had polypectomy or endoscopy during the follow-up period.
“In real world US clinical practice, patients with CRSwNP have similar OCS and HCRU burden, regardless of whether they undergo FESS, signifying substantial treatment burden and unmet need in both groups,” the author concluded.
Reference:
Isaman DL, Khan AH, Lee SE, et al. Oral Corticosteroid Burden and Healthcare resource utilization in Patients with Chronic Rhinosinusitis with Nasal Polyps undergoing Functional Endoscopic Sinonasal Surgery: A real world retrospective cohort study. ARS-COSM, May 4-5, 2023