The course of disease in patients with chronic rhinosinusitis with and without nasal polyps – from topical steroids to antibody therapy

Introduction Chronic rhinosinusitis (CRS) with nasal polyps are now understood as a multifactorial inflammatory disease for several years. Since 2019, antibodies have been added to the previous drug-based, conservative and surgical therapy options.

Material and methods All courses of diseases of patients who presented to our university outpatient clinic for the first time in 2015 due to CRS with and without nasal polyps were evaluated.

Results 228 patients (90 f/138 m; 17-79 years) met the inclusion criteria. CRS was diagnosed in 67% with nasal polyps (CRSwNP), in 33% without polyps (CRSsNP). 18% of patients with CRSwNP had a history of NSAID intolerance. From 2015 to date, 43% of patients have had at least one surgical intervention on their paranasal sinuses (63% with CRSwNP, 4% with CRSsNP). 6 patients with CRSwNP underwent two operations during this period. 12 patients were admitted for inpatient ASA provocation/deactivation. The ASA therapy has been discontinued in all cases to date. 6% of CRSwNP patients are now on long-term therapy with biologics.

Discussion Biologicals as an add-on to nasal corticosteroids are a treatment option for therapy-resistant courses with CRSwNP, which has almost completely replaced long-term treatment with ASA. Nevertheless, a step-by-step approach according tot he current guidelines with primarily conservative and surgical therapy is advisable and is sufficient in the majority of patients.

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Artikel online veröffentlicht:
12. Mai 2023