Age-Specific Risk and Severity of CRS among Cystic Fibrosis Carriers: A Population-Based Cohort Study

Chronic rhinosinusitis (CRS) is an inflammatory disease characterized by congestion and nasal discharge, facial pain and pressure, and loss of smell, with symptoms lasting longer than 3 months. CRS is common among people with cystic fibrosis (CF) and CF carriers are also more at risk for CRS than non-CF carriers. We evaluate risk for CRS across the lifespan for CF carriers and determine how CF carriers with CRS may differ from non-CF carriers with chronic sinusitis.

Using 2001 to 2022 MarketScan data, we developed 2 study populations: (1) a matched cohort consisting of CF carriers who were matched to non-CF carriers, and (2) a cohort of patients with chronic sinusitis. We used the matched cohorts of CF carriers and non-CF carriers to estimate age-group-specific incidence rate ratios for experiencing chronic sinusitis. Next, we used the chronic-sinusitis cohort to compare the severity of chronic sinusitis events between CF carriers and non-carriers. Specifically, we estimated the odds of a sinus procedure or the receipt of antibiotic prescriptions to evaluate the severity and healthcare utilization among CF carriers and non-carriers with CRS. Finally, we compared the odds for developing other CF-related conditions among CF carriers with CRS to non-CF carriers with CRS.

We found that CRS incidence for CF carriers relative to non-CF carriers was highest for those above 40 years of age. We also found that among people with CRS, CF carriers were more likely to undergo a diagnostic evaluation and endoscopic sinus surgery. CF carriers were also more likely to fill antibiotic prescriptions, use multiple antibiotics, and take antibiotics for longer periods.

CF carriers are more likely than non-carriers to suffer from CRS, have more severe CRS, and to exhibit certain features of CF-associated CRS.