Patient perspectives on chronic rhinosinusitis in cystic fibrosis: Symptom prioritization in the era of highly effective modulator therapy-Reference-Cited by-同舟云学术

Patient perspectives on chronic rhinosinusitis in cystic fibrosis: Symptom prioritization in the era of highly effective modulator therapy

Published:2024-02-11 Issue:8 Volume:14 Page:1282-1293
ISSN:2042-6976
Container-title:International Forum of Allergy & Rhinology
language:en
Short-container-title:Int Forum Allergy Rhinol

Author:

Liu Christine M.¹^ORCID,Han Ethan J.¹^ORCID,Fischer Jakob L.¹,Mace Jess C.²,Mattos Jose L.³^ORCID,Markarian Karolin⁴^ORCID,Alt Jeremiah A.⁵^ORCID,Bodner Todd E.⁶,Chowdhury Naweed I.⁷,Eshaghian Patricia H.⁸,Getz Anne E.⁹,Hwang Peter H.¹⁰^ORCID,Khanwalkar Ashoke⁹^ORCID,Kimple Adam J.¹¹,Lee Jivianne T.¹,Li Douglas A.⁸,Norris Meghan¹¹,Nayak Jayakar V.¹⁰^ORCID,Owens Cameran⁹,Patel Zara M.¹⁰^ORCID,Poch Katie¹²,Schlosser Rodney J.¹³,Smith Kristine A.⁵,Smith Timothy L.²^ORCID,Soler Zachary M.¹³,Suh Jeffrey D.¹,Turner Grant A.⁸,Wang Marilene B.¹,Taylor‐Cousar Jennifer L.¹²¹⁴,Saavedra Milene T.¹²,Beswick Daniel M.¹^ORCID

Affiliation:

1. Department of Head and Neck Surgery University of California Los Angeles California USA

2. Department of Otolaryngology—Head and Neck Surgery Oregon Health Sciences University Portland Oregon USA

3. Department of Otolaryngology—Head and Neck Surgery Division of Rhinology and Sinus Surgery University of Virginia Charlottesville Virginia USA

4. CTSI, David Geffen School of Medicine University of California Los Angeles California USA

5. Department of Otolaryngology—Head and Neck Surgery University of Utah Salt Lake City Utah USA

6. Department of Psychology Portland State University Portland Oregon USA

7. Department of Otolaryngology—Head and Neck Surgery Vanderbilt Health Nashville Tennessee USA

8. Department of Pulmonary Medicine University of California Los Angeles California USA

9. Department of Otolaryngology—Head and Neck Surgery University of Colorado Aurora Colorado USA

10. Department of Otolaryngology—Head and Neck Surgery Stanford University Stanford California USA

11. Department of Otolaryngology—Head and Neck Surgery University of North Carolina Chapel Hill North Carolina USA

12. Department of Medicine National Jewish Health Denver Colorado USA

13. Department of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA

14. Department of Pediatrics National Jewish Health Denver Colorado USA

Abstract

AbstractBackgroundChronic rhinosinusitis (CRS) is common in people with cystic fibrosis (PwCF). Rhinologic symptom prioritization and areas that influence CRS treatment choices, including pursuing endoscopic sinus surgery (ESS), remain understudied.MethodsAdult PwCF + CRS were enrolled at eight centers into a prospective, observational study (2019–2023). Participants were administered the 22‐SinoNasal Outcome Test (SNOT‐22) survey and a modified SNOT‐22 instrument examining symptom importance. We determined importance rankings for individual symptoms and SNOT‐22 symptom importance subdomains in two sets of subgroups—those pursuing ESS versus continuing medical management (CMT), and those on elexacaftor/tezacaftor/ivacaftor (ETI) versus not on ETI.ResultsAmong 69 participants, the highest priorities were nasal congestion (n = 48, 69.6% important), post‐nasal discharge (32, 46.4%), facial pain (29, 43.3%), waking up tired (27, 39.1%), and fatigue (26, 37.7%). Those electing surgery (n = 23) prioritized sleep and psychological dysfunction symptoms compared to those pursuing CMT (n = 49) (sleep median score = 19.0 [interquartile range: 12.0, 25.0] vs. 4.5 [0.0, 12.8]; p < 0.0001; psychological = 17.0 [7.0, 26.0] vs. 7.0 [0.0, 15.8]; p = 0.002). ETI users had comparable SNOT‐22 total symptom importance scores to non‐ETI users (p = 0.14). Non‐ETI users (n = 34) showed a trend toward prioritizing sleep symptoms compared to ETI users (n = 35) (13.0 [2.8, 22.3] vs. 6.0 [2.0, 17.0]; p = 0.055).ConclusionsNasal congestion and post‐nasal discharge were top priorities reported by PwCF + CRS. Those electing surgery prioritized sleep and psychological symptoms, highlighting their importance in pre‐operative discussions. Non‐ETI users’ prioritization of sleep improvement may highlight their unique disease impact and therapeutic needs; however, additional investigation is required.

Funder

National Institute on Deafness and Other Communication Disorders

Cystic Fibrosis Foundation

Publisher

Wiley

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1002/alr.23332

Reference33 articles.

1. A systematic review of studies examining the rate of lung function decline in patients with cystic fibrosis

2. Management of the upper airway in cystic fibrosis

3. Elexacaftor-Tezacaftor- Ivacaftor improves sinonasal outcomes in cystic fibrosis

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1. Impact of sociodemographic status and sex on chronic rhinosinusitis and olfaction in people with cystic fibrosis;International Forum of Allergy & Rhinology;2024-07-05

2. In Response to Predictors of Sinonasal Improvement After Highly Effective Modulator Therapy in Adults with Cystic Fibrosis;The Laryngoscope;2024-06-22