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Allergic Rhinitis Amplifies Asthma Risk in Patients With Chronic Rhinosinusitis: A Large-Scale Retrospective Cohort

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Chronic rhinosinusitis (CRS) increases asthma risk, especially with allergic rhinitis (AR). Managing upper airway conditions may reduce asthma burden.

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Area of Science:

  • Respiratory Medicine
  • Epidemiology
  • Clinical Research

Background:

  • Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) are common airway diseases.
  • The link between CRS, AR, and new-onset asthma requires further investigation.
  • Electronic health records (EHR) offer insights into disease development and comorbidities.

Purpose of the Study:

  • To assess the impact of CRS on incident asthma development.
  • To evaluate the role of comorbid AR in amplifying asthma risk in CRS patients.
  • To analyze asthma exacerbations in relation to CRS and AR.

Main Methods:

  • Retrospective cohort study using the TriNetX EHR network (over 100 million patients).
  • Comparison of adults with CRS versus controls, and CRS with AR versus CRS alone.
  • Propensity score matching to balance cohorts; assessment of asthma incidence and exacerbations over 1, 2, and 5 years.

Main Results:

  • CRS significantly increased the risk of new-onset asthma and exacerbations.
  • Concurrent AR further elevated asthma incidence and more than doubled exacerbation risk in CRS patients.
  • Similar trends were observed for chronic rhinosinusitis with nasal polyps (CRSwNP).

Conclusions:

  • CRS is a risk factor for incident asthma and subsequent exacerbations.
  • Patients with CRS and AR represent a high-risk phenotype for asthma.
  • Targeted upper airway management strategies may be crucial for mitigating asthma burden.