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Key points: Increased dupilumab utilization coincided with decreased ESS in patients with CRSwNP between 2019 and 2021.One potential confounder was the concurrent COVID‐19 pandemic, which may have negatively impacted surgery utilization rates. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Elexacaftor/tezacaftor/ivacaftor (ETI), a combination cystic fibrosis transmembrane receptor (CFTR) modulator, has demonstrated improved pulmonary outcomes in individuals with cystic fibrosis (CF). However, ETI's impact on functional endoscopic sinus surgery (FESS) remains unclear.The TriNetX Analytics Research Network, consisting of 120 million global de‐identified electronic medical records, was queried from 2012 to 2023 for subjects with CF who underwent sinus surgery.1 Patients on ETI prior to FESS (n = 6,056) were propensity score matched to control individuals with CF not on CFTR modulators (n = 37,906) and those on other FDA‐approved CFTR modulators (tezacaftor/ivacaftor, lumacaftor/ivacaftor, and ivacaftor) (n = 2437) based on relevant factors. The primary outcome was the absolute risk reduction (ARR) of undergoing FESS. Secondary outcomes included ARR of CF‐related pulmonary exacerbations and hospital admission from 0 to 6, 6 to 12, and 12 to 24 months following FESS.ETI use demonstrated a significant ARR for FESS when compared to CF patients not on CFTR modulators (2.12%; 95% confidence interval [CI] 1.5–2.75; p‐value < 0.0001) and those on other CFTR modulators (4.7%; 95% CI 3.54–5.85; p‐value < 0.0001). No significant differences occurred in secondary outcomes between ETI and non‐CFTR modulator groups, except for reduced CF‐related pulmonary exacerbations from 0 to 6 months post‐FESS. Additionally, a significant reduction in pulmonary exacerbations was observed at all time points and hospital admissions within 6 months following FESS compared to those using other CFTR modulators.In a large dataset, CF patients on ETI demonstrated significantly reduced risk of FESS, pulmonary exacerbations, and hospital admission compared to patients not on CFTR modulators or those on other CFTR modulators, suggesting improved sinonasal disease and overall health status in CF. [ABSTRACT FROM AUTHOR]

Background: The placebo effect observed in clinical trials evaluating medical treatments for chronic rhinosinusitis (CRS) is not well understood. This systematic review and meta‐analysis sought to characterize the placebo effect present within CRS outcomes. Methods: A systematic review of PubMed, Scopus, and Cumulated Index in Nursing and Allied Health Nursing (CINAHL) was performed. Randomized controlled trials (RCTs) evaluating medical treatments for CRS versus placebo were included. We assessed patient‐reported (sino‐nasal outcome test 22 [SNOT‐22], nasal obstruction, sense of smell, nasal obstruction visual analogue score [VAS], sense of smell VAS, anterior rhinorrhea, and postnasal drip) and objective (Lund–Mackay Computed tomography (CT) score, peak nasal inspiratory flow [PNIF], nasal polyp scores, 40‐item Smell Identification Test, serum IgE, and blood eosinophil levels) outcomes. Results: Twenty‐one RCTs were included, comprising 1437 patients (mean age 49.2 years). Biologics were the most common treatment investigated (n = 9). Eleven studies administered background steroids along with placebo. Following placebo administration, multiple patient‐reported outcomes significantly decreased, including SNOT‐22 (mean difference −9.49, 95% confidence interval [CI] [−11.26, −7.73]), nasal obstruction (−0.33 [−0.54, −0.13]), sense of smell (−0.22 [−0.33, −0.11]), nasal obstruction VAS (−2.47 [−2.87, −2.06]), and loss of smell VAS (−2.31 [−4.14, −0.47]) scores. For objective measures, significant changes occurred in Lund–Mackay CT score (−0.82, [−1.48, −0.16]) and PNIF (4.70, [4.76, 24.64]) with placebo. Placebo arms had the greatest impact when no background medications were used. Conclusions: Placebo treatments have a statistically and potentially clinically significant effect on patient‐reported and some objective CRS outcomes. Further investigation is required to fully understand placebo effect, which could improve assessment of RCTs and impact patient care. [ABSTRACT FROM AUTHOR]