Factors that predict pursuing sinus surgery in the era of highly effective modulator therapy
© 2023 ARS‐AAOA, LLC..
BACKGROUND: Comorbid chronic rhinosinusitis (CRS) remains unresolved for many people with cystic fibrosis (PwCF). While highly effective modulator therapy improves quality-of-life and symptom severity, the impact of this intervention and other factors associated with pursuing endoscopic sinus surgery (ESS) remains understudied.
METHODS: Adult PwCF + CRS were enrolled into a prospective, observational, multi-institutional study. Participants completed validated outcome measures to evaluate respiratory symptom severity, depression, headache, and sleep quality, as well as nasal endoscopy, sinus computed tomography (CT), and olfactory testing. Bivariate comparisons and regression modeling evaluated treatment cofactors, disease characteristics, and outcome measures associated with pursuing ESS.
RESULTS: Sixty PwCF were analyzed, including 24 (40%) who elected ESS. Pursuing ESS was associated with worse SinoNasal Outcome Test (SNOT-22) total, rhinologic, psychological, and sleep dysfunction domain scores; worse Patient Health Questionnaire-9-Revised depression scores; worse Pittsburgh Sleep Quality Index total scores; worse weight, role, emotion, and eating domain scores on the Cystic Fibrosis Questionnaire-Revised; more severe disease on nasal endoscopy; and lack of modulator therapy (all p < 0.050). Multivariable regression identified that worse SNOT-22 total score was associated with electing ESS (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02-1.16, p = 0.015) and elexacaftor/tezacaftor/ivacaftor (ETI) treatment (OR 0.04, 95% CI 0.004-0.34, p = 0.004) was associated with pursing medical therapy.
CONCLUSIONS: Worse sinonasal symptom burden, lack of ETI treatment, sleep quality, depression, and nasal endoscopy scores were associated with electing ESS, while lung disease severity and sinus CT scores were not. ETI use was associated with lower odds of pursuing ESS independent of sinonasal symptom burden.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
|---|---|
| Enthalten in: |
International forum of allergy & rhinology - 14(2024), 4 vom: 01. Apr., Seite 807-818 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Beswick, Daniel M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Chronic rhinosinusitis |
|---|
| Anmerkungen: |
Date Completed 03.04.2024 Date Revised 03.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/alr.23270 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM362218994 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM362218994 | ||
| 003 | DE-627 | ||
| 005 | 20240403234938.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/alr.23270 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1362.xml |
| 035 | |a (DE-627)NLM362218994 | ||
| 035 | |a (NLM)37725072 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Beswick, Daniel M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Factors that predict pursuing sinus surgery in the era of highly effective modulator therapy |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 03.04.2024 | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 ARS‐AAOA, LLC. | ||
| 520 | |a BACKGROUND: Comorbid chronic rhinosinusitis (CRS) remains unresolved for many people with cystic fibrosis (PwCF). While highly effective modulator therapy improves quality-of-life and symptom severity, the impact of this intervention and other factors associated with pursuing endoscopic sinus surgery (ESS) remains understudied | ||
| 520 | |a METHODS: Adult PwCF + CRS were enrolled into a prospective, observational, multi-institutional study. Participants completed validated outcome measures to evaluate respiratory symptom severity, depression, headache, and sleep quality, as well as nasal endoscopy, sinus computed tomography (CT), and olfactory testing. Bivariate comparisons and regression modeling evaluated treatment cofactors, disease characteristics, and outcome measures associated with pursuing ESS | ||
| 520 | |a RESULTS: Sixty PwCF were analyzed, including 24 (40%) who elected ESS. Pursuing ESS was associated with worse SinoNasal Outcome Test (SNOT-22) total, rhinologic, psychological, and sleep dysfunction domain scores; worse Patient Health Questionnaire-9-Revised depression scores; worse Pittsburgh Sleep Quality Index total scores; worse weight, role, emotion, and eating domain scores on the Cystic Fibrosis Questionnaire-Revised; more severe disease on nasal endoscopy; and lack of modulator therapy (all p < 0.050). Multivariable regression identified that worse SNOT-22 total score was associated with electing ESS (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02-1.16, p = 0.015) and elexacaftor/tezacaftor/ivacaftor (ETI) treatment (OR 0.04, 95% CI 0.004-0.34, p = 0.004) was associated with pursing medical therapy | ||
| 520 | |a CONCLUSIONS: Worse sinonasal symptom burden, lack of ETI treatment, sleep quality, depression, and nasal endoscopy scores were associated with electing ESS, while lung disease severity and sinus CT scores were not. ETI use was associated with lower odds of pursuing ESS independent of sinonasal symptom burden | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a chronic rhinosinusitis | |
| 650 | 4 | |a cystic fibrosis | |
| 650 | 4 | |a endoscopic sinus surgery | |
| 650 | 4 | |a highly effective modulator therapy | |
| 650 | 4 | |a patient symptoms | |
| 700 | 1 | |a Han, Ethan J |e verfasserin |4 aut | |
| 700 | 1 | |a Mace, Jess C |e verfasserin |4 aut | |
| 700 | 1 | |a Markarian, Karolin |e verfasserin |4 aut | |
| 700 | 1 | |a Alt, Jeremiah A |e verfasserin |4 aut | |
| 700 | 1 | |a Bodner, Todd E |e verfasserin |4 aut | |
| 700 | 1 | |a Chowdhury, Naweed I |e verfasserin |4 aut | |
| 700 | 1 | |a Eshaghian, Patricia H |e verfasserin |4 aut | |
| 700 | 1 | |a Getz, Anne E |e verfasserin |4 aut | |
| 700 | 1 | |a Hwang, Peter H |e verfasserin |4 aut | |
| 700 | 1 | |a Khanwalkar, Ashoke |e verfasserin |4 aut | |
| 700 | 1 | |a Kimple, Adam J |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jivianne T |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Douglas A |e verfasserin |4 aut | |
| 700 | 1 | |a Norris, Meghan |e verfasserin |4 aut | |
| 700 | 1 | |a Nayak, Jayakar V |e verfasserin |4 aut | |
| 700 | 1 | |a Owens, Cameran |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Zara |e verfasserin |4 aut | |
| 700 | 1 | |a Poch, Katie |e verfasserin |4 aut | |
| 700 | 1 | |a Schlosser, Rodney J |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Kristine A |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Timothy L |e verfasserin |4 aut | |
| 700 | 1 | |a Soler, Zachary M |e verfasserin |4 aut | |
| 700 | 1 | |a Suh, Jeffrey D |e verfasserin |4 aut | |
| 700 | 1 | |a Turner, Grant |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Marilene B |e verfasserin |4 aut | |
| 700 | 1 | |a Taylor-Cousar, Jennifer L |e verfasserin |4 aut | |
| 700 | 1 | |a Saavedra, Milene |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International forum of allergy & rhinology |d 2011 |g 14(2024), 4 vom: 01. Apr., Seite 807-818 |w (DE-627)NLM209105178 |x 2042-6984 |7 nnns |
| 773 | 1 | 8 | |g volume:14 |g year:2024 |g number:4 |g day:01 |g month:04 |g pages:807-818 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/alr.23270 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 14 |j 2024 |e 4 |b 01 |c 04 |h 807-818 | ||