Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2026
Socioeconomic and Demographic Influences on Biologic Treatment Outcomes in Patients With Chronic Rhinosinusitis.
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Biadsee Ameen, Kassem Firas, Shenfeld Itamar, Cohen Michael Ori, Gernshbel-Milk Dafna, Boldes Tomer
Аннотация
IMPORTANCE: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory disease that significantly impairs quality of life (QOL) and imposes a substantial economic burden. Socioeconomic and demographic factors influence access to care, treatment adherence, and outcomes, yet their impact on response to biologic therapy remains poorly defined.
OBJECTIVE: To examine the impact of socioeconomic and demographic determinants on symptom severity and QOL before and after monoclonal antibody therapy for CRSwNP.
DESIGN: Exploratory retrospective cohort study with prospective socioeconomic and demographic data curation.
SETTING: Tertiary medical center.
PARTICIPANTS: Adults with recalcitrant CRSwNP from January 2020 to January 2024 who had undergone endoscopic sinus surgery and completed a 16-week regimen of monoclonal antibody therapy.Intervention or Exposures:The primary exposures evaluated were socioeconomic status (SES; including household income) and demographic determinants.
MAIN OUTCOME MEASURES: Baseline and post-treatment (16 weeks) follow-up of 22-item Sino-Nasal Outcome Test (SNOT-22) and Meltzer grading evaluation.
RESULTS: Forty patients (21 males and 19 females; mean age 50.4 ± 12.1) were included. The mean baseline SNOT-22 score was 69.0 ± 15.8, and the median Meltzer score was 3 (interquartile range [IQR]: 2-3.75). At 16-week follow-up, these scores improved to 33.8 ± 20.5 and 1 (IQR: 0-2), respectively. Low-income patients (<40 000 United States Dollar [USD] yearly) had worse baseline SNOT-22 scores compared to medium (40 001-80 000 USD yearly) and high-income patients (>80 000 USD yearly; 79.4 vs 68.6 vs 57.1, respectively, P < .01) but showed the largest absolute point reduction (ΔSNOT-22, 47.8 vs 34.7 vs 20.8, respectively, P = .01). Low-income patients showed the largest absolute improvement after biologic treatment (P = .01); however, covariate adjustment for baseline scores showed similar proportional effects across all income tiers.
CONCLUSIONS: Patients with lower incomes exhibited higher baseline disease severity. However, biologic treatment yielded meaningful absolute improvement in QOL across all SES tiers.
RELEVANCE: Recognizing socioeconomic factors may help optimize biologic therapy in CRS. Future multi-center research is needed to validate these disparities and optimize intervention strategies.
OBJECTIVE: To examine the impact of socioeconomic and demographic determinants on symptom severity and QOL before and after monoclonal antibody therapy for CRSwNP.
DESIGN: Exploratory retrospective cohort study with prospective socioeconomic and demographic data curation.
SETTING: Tertiary medical center.
PARTICIPANTS: Adults with recalcitrant CRSwNP from January 2020 to January 2024 who had undergone endoscopic sinus surgery and completed a 16-week regimen of monoclonal antibody therapy.Intervention or Exposures:The primary exposures evaluated were socioeconomic status (SES; including household income) and demographic determinants.
MAIN OUTCOME MEASURES: Baseline and post-treatment (16 weeks) follow-up of 22-item Sino-Nasal Outcome Test (SNOT-22) and Meltzer grading evaluation.
RESULTS: Forty patients (21 males and 19 females; mean age 50.4 ± 12.1) were included. The mean baseline SNOT-22 score was 69.0 ± 15.8, and the median Meltzer score was 3 (interquartile range [IQR]: 2-3.75). At 16-week follow-up, these scores improved to 33.8 ± 20.5 and 1 (IQR: 0-2), respectively. Low-income patients (<40 000 United States Dollar [USD] yearly) had worse baseline SNOT-22 scores compared to medium (40 001-80 000 USD yearly) and high-income patients (>80 000 USD yearly; 79.4 vs 68.6 vs 57.1, respectively, P < .01) but showed the largest absolute point reduction (ΔSNOT-22, 47.8 vs 34.7 vs 20.8, respectively, P = .01). Low-income patients showed the largest absolute improvement after biologic treatment (P = .01); however, covariate adjustment for baseline scores showed similar proportional effects across all income tiers.
CONCLUSIONS: Patients with lower incomes exhibited higher baseline disease severity. However, biologic treatment yielded meaningful absolute improvement in QOL across all SES tiers.
RELEVANCE: Recognizing socioeconomic factors may help optimize biologic therapy in CRS. Future multi-center research is needed to validate these disparities and optimize intervention strategies.