Utilization patterns of systemic corticosteroid use for chronic rhinosinusitis

Abstract

Objective: We sought to characterize the utilization pattern and factors associated with use of systemic corticosteroids for CRS.

Methods: This was a cross-sectional study of 236 participants with CRS who were prospectively recruited. Participants reported the number of CRS-related oral corticosteroid courses taken in the last year. Baseline CRS symptomatology was measured using the 22-item Sinonasal Outcome Test (SNOT-22) and SNOT-22 sleep, nasal, otologic/facial pain and emotional subdomain scores. Clinical and demographic characteristics were also collected. Association was determined between patient characteristics and oral corticosteroid use in the last year for CRS.

Results: Sleep (p = .026), nasal (p < .001) and otologic/facial pain (p = .022) SNOT-22 subdomain scores, and nasal polyps (p = .007) were associated with CRS-related oral corticosteroid use. In study participants without polyps, past CRS-related oral corticosteroid use was associated with sleep (adjusted OR = 1.56, 95%CI: 1.01–2.40, p = .043), otologic/facial pain (adjusted OR = 1.65, 95%CI: 1.09–2.51, p = .019) and nasal subdomain scores (adjusted OR = 1.59, 95%CI: 1.01–2.51, p = .047). In study participants with polyps, past CRS-related oral corticosteroid use was only associated with the nasal subdomain score (adjusted OR = 2.20, 95%CI: 1.40–3.45, p = .001).

Conclusions: Past CRS-related oral corticosteroid use was associated with increased baseline severity of specific symptoms, which were different depending on the presence of polyps.

Chinese abstract

目的：我们试图发现关于将全身性皮质类固醇用于CRS患者的运用模式和因素的特征。

方法：对236名前瞻性招募的CRS患者进行横向研究。参与者报告了去年服用与CRS相关的口服皮质类固醇类药物的疗程数量。使用22项鼻腔结果测试（SNOT-22）和SNOT-22睡眠、鼻、耳部/面部疼痛和情绪子域值测量了基线C RS症状 。还收集了临床和人口特征。确定了去年的CRS患者特征和口服皮质类固醇使用之间的相关性。

结果：睡眠（p = 0.026）、鼻痛（p <0.001）和耳部/面部疼痛（p = 0.022）SNOT-22子域值和鼻息肉（p = .007）与CRS口腔皮质类固醇的使用具有相关性。在无息肉研究参与者中, 过去的CRS口服皮质类固醇使用与睡眠（经调整的OR =1.56, 95％CI：1.01-2.40, p = 0.043）、耳部/面部疼痛（经调整的OR =1.65, 95％CI ：1.09-2.51, p = 0.019）和鼻子域值（经调整的OR =1.59, 95％CI：1.01-2.51, p = 0.047）具有相关性。在有息肉的研究参与者中, 过去的CRS口服皮质类固醇使用仅与鼻子域值相关（经调整的OR =2.20, 95％CI：1.40-3.45, p = 0.001）。

结论：过去CRS口服皮质类固醇使用与特定症状的基线严重程度的提高相关, 并随着息肉的存在与否而有差异。

Keywords:

• Chronic rhinosinusitis
• oral corticosteroids
• polyps
• SNOT-22
• sleep
• nasal symptoms
• otologic symptoms
• facial pain
• emotional symptoms
• principal component analysis

Acknowledgements

The authors gratefully acknowledge the contribution of the patients who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.