Chronic Rhinosinusitis Outcomes of Patients With Aspirin-Exacerbated Respiratory Disease Treated With Budesonide Irrigations: A Case Series.
Publication/Presentation Date
10-1-2022
Abstract
BACKGROUND: Pathophysiology-targeting treatments exist for aspirin-exacerbated respiratory disease (AERD) through aspirin desensitization and biologics, such as dupilumab. With increasing attention paid to these treatments, which may be associated with significant side effects and/or cost, there is little description of chronic rhinosinusitis with nasal polyps (CRSwNP) response to treatment with intranasal corticosteroids and saline irrigations in AERD.
OBJECTIVE: To determine the effect of intranasal budesonide irrigations for the treatment of CRSwNP in AERD.
METHODS: This is an observational study of 14 AERD patients presenting to a rhinology clinic for CRS who were treated with twice daily high volume, low pressure irrigations with 240 mL of saline to which a 0.5 mg/2 mL respule of budesonide was added. All participants completed a 22-item Sinonasal Outcome Test (SNOT-22) at enrollment and at follow up 1 to 6 months later. Polyp scores were also calculated at each time point.
RESULTS: SNOT-22 scores ranged from 26 to 98 (median: 40.5) at enrollment and 3 to 85 (median: 38.5) at follow-up. Polyp scores ranged from 2 to 6 (median: 4) at enrollment at 0 to 6 (median: 2) at follow-up. Over the treatment period, change in SNOT-22 score ranged from -38 to 16 (median: -18) and change in polyp score ranged from -2 to 0 (median: -0.5). Approximately 57% of participants experienced at least 1 minimal clinically important difference in SNOT-22 score and 21% of participants had a SNOT-22 score < 20 at follow-up.
CONCLUSION: Medical management with intranasal corticosteroids and saline irrigations alone leads to significant improvement in sinonasal symptomatology in a subset of AERD.
Volume
131
Issue
10
First Page
1130
Last Page
1136
ISSN
1943-572X
Published In/Presented At
Talat, R., Gengler, I., Phillips, K. M., Caradonna, D. S., Gray, S. T., & Sedaghat, A. R. (2022). Chronic Rhinosinusitis Outcomes of Patients With Aspirin-Exacerbated Respiratory Disease Treated With Budesonide Irrigations: A Case Series. The Annals of otology, rhinology, and laryngology, 131(10), 1130–1136. https://doi.org/10.1177/00034894211054948
Disciplines
Medicine and Health Sciences
PubMedID
34775833
Department(s)
Department of Surgery, Division of Otolaryngology
Document Type
Article