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Burden of Disease in Chronic Rhinosinusitis with Nasal Polyps

Authors Bachert C, Bhattacharyya N, Desrosiers M, Khan AH

Received 6 November 2020

Accepted for publication 24 December 2020

Published 11 February 2021 Volume 2021:14 Pages 127—134


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Luis Garcia-Marcos

Claus Bachert,1,2 Neil Bhattacharyya,3 Martin Desrosiers,4 Asif H Khan1,5

1Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University, Ghent, Belgium; 2CLINTEC, Karolinska Institutet, Stockholm, Sweden; 3Department of Otolaryngology, Harvard Medical School, Boston, MA, USA; 4Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada; 5Sanofi, Chilly-Mazarin, France

Correspondence: Claus Bachert
Upper Airways Research Laboratory, Ghent University, C. Heymanslaan 10, Ghent, B-9000, Belgium
Tel +32 9 332 6880

Abstract: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammation-mediated disease of the nasal mucosa and paranasal sinuses with an under-recognized clinical, humanistic, and economic burden. Patients with CRSwNP experience a high symptom burden, including nasal congestion, loss of smell, and rhinorrhea, which has a negative impact on physical and mental health-related quality of life, including sleep quality. Existing medical and surgical interventions, including local and systemic corticosteroids and endoscopic sinus surgery, may be associated with recurrence of nasal polyps and associated symptoms and with an increased risk of short- and long-term adverse effects, especially with repeated or long-term use. Because type 2 inflammation is implicated in the pathogenesis of several coexisting diseases, patients with CRSwNP often have comorbid asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease. These patients, as well as those with high corticosteroid use and/or sinonasal surgical history, have more severe disease and associated symptom burden and represent a difficult-to-treat population under the existing management paradigm. This article reviews the clinical, humanistic, and economic burden of CRSwNP; it highlights the unmet need for effective and safe CRSwNP therapies that effectively control symptoms and minimize recurrence by targeting the underlying type 2 inflammatory disease pathophysiology.

Keywords: disease severity, healthcare economics, paranasal sinus disease, quality of life

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