Non-invasive biosignature for CRSwNP: Therapeutic monitoring and recurrence prediction

Introduction Functional endoscopic sinus surgery (FESS) and a medical therapy consisting of topical and oral steroids remain gold standard for chronic rhinosinusitis with nasal polyps (CRSwNP). Despite recent advances, the treatment effect as well as the prediction of recurrences remain elusive. The objective of this study is to solve these shortcomings.

Methods Prospective, randomized study of n = 61 patients suffering from CRSwNP. All patients underwent FESS and a postoperative topical therapy with a steroid spray for 3 months. Additionally, patients were treated with either a placebo (n = 28) or an oral steroid taper (n = 33) for 1 month. The follow-up was 2 years over 10 time points. At each time point, a nasal endoscopy (nasal polyp score, NPS) as well as subjective (SNOT-22, RSDI, SF-36) and objective parameters (mucosal biomarker including Periostin, PAPP-A, SerpinE1, SerpinF2, CST1) were collected.

Results There was no significant difference between the placebo and the steroid groups concerning the SNOT-22 and the RSDI (p = 0.081, p < 0.001). In 2 subgroups of the SF-36 the placebo group was significantly better (p < 0.001,p = 0.034). The NPS showed no differences between the groups (p = 0.273).SerpinE1 and SerpinF2 showed significant differences between the 2 groups (p < 0.001,p = 0.05). Periostin, PAPP-A and CST1 distinguished significantly between an early and late recurrence group (p < 0.05 for all).

Conclusion Topical and systemic steroids show no differences neither in effect nor in side effects. Periostin, PAPP-A and CST1 can be used for recurrence prediction.

Poster-PDF A-1085.PDF

Publication History

Article published online:
10 June 2020