Search

Background Methods Results Conclusions Clinical Trials Sociodemographic status (SDS) including race/ethnicity and socioeconomic status as approximated by education, income, and insurance status impact pulmonary disease in people with cystic fibrosis (PwCF). The relationship between SDS and chronic rhinosinusitis (CRS) remains understudied.In a prospective, multi‐institutional study, adult PwCF completed the 22‐Question SinoNasal Outcome Test (SNOT‐22), Smell Identification Test (SIT), Questionnaire of Olfactory Disorder Negative Statements (QOD‐NS), and Cystic Fibrosis Questionnaire‐Revised (CFQ‐R). Lund–Kennedy scores, sinus computed tomography, and clinical data were collected. Data were analyzed across race/ethnicity, sex, and socioeconomic factors using multivariate regression.Seventy‐three PwCF participated with a mean age of 34.7 ± 10.9 years and 49 (67.1%) were female. Linear regression identified that elexacaftor/tezacaftor/ivacaftor (ETI) use (β = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], p < 0.001), female sex (β = ‒2.14, 95% CI [‒4.11, ‒0.17], p = 0.034), and increasing age (β = ‒0.14, 95% CI [‒0.22, ‒0.05], p = 0.003) were associated with lower/better endoscopy scores. Private health insurance (β = 17.76, 95% CI [5.20, 30.32], p = 0.006) and >16 educational years (β = 13.50, 95% CI [2.21, 24.80], p = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV1). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ‐R respiratory scores, and ppFEV1 (all p < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT‐22 scores (p = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT‐22, QOD‐NS, or SIT scores.Differences in objective measures of CRS severity exist among PwCF related to sex, age, and ETI use. Variant status and race did not influence patient‐reported CRS severity measures or olfaction in this study. Understanding how these factors impact response to treatment may improve care disparities among PwCF.NCT04469439 [ABSTRACT FROM AUTHOR]

Keywords: chronic rhinosinusitis; quality of life; CRS; SNOT-22; QOL; NOSE; BHLS; health literacy EN chronic rhinosinusitis quality of life CRS SNOT-22 QOL NOSE BHLS health literacy 818 821 4 03/25/21 20210401 NES 210401 Health literacy describes patients' ability to synthesize information from healthcare professionals in order to make decisions about their care. Patients with inadequate health literacy are 3 times more likely to experience poor outcomes, including increased mortality and increased hospitalization rates.1 To date, no studies have examined health literacy among rhinologic patients. [Extracted from the article]

Background Methods Results Conclusions Chronic 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.Adult 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.Among 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).Nasal 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. [ABSTRACT FROM AUTHOR]

This article discusses the impact of dupilumab, a medication used to treat chronic rhinosinusitis with nasal polyposis (CRSwNP), on military readiness in a military population. The study found that military servicemembers reported high satisfaction rates with dupilumab treatment for CRSwNP. However, some servicemembers expressed concerns that the treatment may limit their career progression. The article suggests that updated guidelines are needed to help servicemembers make informed decisions about dupilumab treatment. The study concludes that dupilumab therapy did not appear to limit career progression in the military population studied, but further research and guidance are necessary. [Extracted from the article]