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Systemic medication requirement in post-surgical patients with eosinophilic chronic rhinosinusitis.
Ho, J; Li, W; Grayson, J W; Alvarado, Raquel; Rimmer, J; Sewell, W A; Harvey, R J.
Afiliación
  • Ho J; Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia;St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia.
  • Li W; Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Grayson JW; Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Alvarado R; Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Rimmer J; Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia; Woolcock Institute, University of Sydney, Sydney, Australia; Faculty of Medicine, Notre Dame University, Sydney, Australia.
  • Sewell WA; St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia; Immunology Division, Garvan Institute of Medical Research, Sydney, Australia.
  • Harvey RJ; Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Rhinology ; 59(1): 59-65, 2021 Feb 01.
Article en En | MEDLINE | ID: mdl-32720937
BACKGROUND: Eosinophilic chronic rhinosinusitis (eCRS) is contemporarily managed by surgical creation of a 'neo-sinus' cavity and corticosteroid irrigations. While most patients gain control of their disease with this approach, similar to preventive inhaler therapy in asthma, some patients need systemic therapies. This study aimed to define those patients needing ongoing systemic therapy for eCRS. METHODS: Consecutive adult patients (>18 years) who were seen at a tertiary referral clinic, diagnosed as eCRS and underwent endoscopic sinus surgery were included. Patients were followed up for a minimum of 12 months. All patients had a simple neo- sinus cavity surgically created and used initially a once daily topical corticosteroid irrigation maintenance therapy. Patients who re- quired long term systemic oral corticosteroids and/or biologic therapy were compared to those who remained on topical control. RESULTS: 222 patients with eCRS were assessed (follow-up 2.76 years). Long term systemic therapy was required in 5.4% of pa- tients. Receiver operating curve analysis predicted local treatment failure at an eosinophil count cut-off level 0.455x109/L. Asthma, atopy and aspirin sensitivity also predicted long term systemic therapy. There were no associations with nasal polyposis or revi- sion surgery. Multivariate logistic regression showed elevated blood eosinophil count >0.455 x109/L was 9.27 times more likely to require for systemic medication. CONCLUSION: Pre-operative blood eosinophil count >0.45 x109/L was associated with failure of local therapy following contem- porary management of eCRS. The quantitative value of serum eosinophilia may be a useful predictor of disease progression and those patients in need of systemic therapies, such as biologic agents.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sinusitis / Rinitis / Pólipos Nasales / Eosinofilia Límite: Adult / Humans Idioma: En Revista: Rhinology Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sinusitis / Rinitis / Pólipos Nasales / Eosinofilia Límite: Adult / Humans Idioma: En Revista: Rhinology Año: 2021 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Países Bajos