Chronic rhinosinusitis severity is associated with need for asthma-related systemic corticosteroids

Area of Science:

• Otolaryngology
• Pulmonology
• Allergy and Immunology

Background:

• Chronic rhinosinusitis (CRS) is common in asthma patients.
• The link between CRS severity and asthma control, specifically oral corticosteroid use, remains unevaluated.
• Oral corticosteroid use indicates poor asthma control and prognosis.

Purpose of the Study:

• To investigate the association between chronic rhinosinusitis severity and asthma-related oral corticosteroid use.
• To determine if CRS severity metrics can predict the need for oral corticosteroids in asthma patients.

Main Methods:

• A prospective cross-sectional study included 110 adult asthma patients with CRS.
• CRS severity was assessed using the 22-item Sinonasal Outcomes Test (SNOT-22) and Lund-Kennedy endoscopy score.
• Asthma-related oral corticosteroid use in the past year was recorded. Receiver operating characteristic (ROC) curves were used to evaluate predictive values.

Main Results:

• The SNOT-22 score, but not the endoscopy score, was significantly associated with asthma-related oral corticosteroid use (OR=1.03, p=0.003).
• A 21-point increase in SNOT-22 score corresponded to a 2-fold increase in the odds of oral corticosteroid use.
• ROC analysis indicated SNOT-22 scores >32 (high sensitivity) or >65 (high specificity) could detect past oral corticosteroid use.

Conclusions:

• Increased chronic rhinosinusitis symptom severity is linked to past oral corticosteroid use in asthma patients.
• The SNOT-22 score is a valuable tool for screening asthma patients with CRS for oral corticosteroid use.
• SNOT-22 can identify patients at higher risk of poor asthma control requiring oral corticosteroids.