The journal of allergy and clinical immunology. Global · 2026
Identification of severe eosinophilic asthma in patients with chronic rhinosinusitis and nasal polyps who are awaiting sinus surgery.
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Davies Drew, Royston Alexander, Hudson Elizabeth, Davidson James, Chisholm Edward, Shrikrishna Dinesh
Аннотация
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common comorbidity within severe asthma populations; its presence is associated with increased severity of disease and eosinophilic inflammation that may require biologic therapies.
OBJECTIVE: We sought to identify potential patients with severe eosinophilic asthma in a population of patients with CRSwNP who were awaiting functional endoscopic sinus surgery (FESS) for nasal polyps.
METHODS: We conducted a service evaluation of patients with CRSwNP who were awaiting FESS in a district general hospital. We screened electronic records for eosinophil levels, previous asthma diagnosis, symptoms, and medical treatment.
RESULTS: Of the 709 patients on the otolaryngology waiting list, 123 patients with CRSwNP were awaiting FESS. Of those patients, 74 had previous eosinophilia (serum eosinophil count ≥ 0.3 x109/L), 32% were female, and their mean age was 53.5 years (SD 15 years). Of those 74 patients, 36 had a preexisting diagnosis of asthma, of whom 61% were at step 4 or 5 of the Global Initiative for Asthma guidelines, with 18% receiving 2 or more courses of oral steroids in the previous 12 months, 41% unknown to local asthma services, and 27% receiving biologic therapy for asthma. In addition, of those with eosinophilia with no previous asthma diagnosis who were awaiting FESS for nasal polyps (38 of 74), 26% had documented symptoms of breathlessness or wheeze.
CONCLUSION: We have identified patients with CRSwNP awaiting nasal polyp surgery who have eosinophillic asthma that may benefit from treatment optimization and review in a severe asthma service. Proactive identification of patients with severe asthma and comorbid CRSwNP who are currently awaiting FESS may widen access to asthma optimization and biologic medications.
OBJECTIVE: We sought to identify potential patients with severe eosinophilic asthma in a population of patients with CRSwNP who were awaiting functional endoscopic sinus surgery (FESS) for nasal polyps.
METHODS: We conducted a service evaluation of patients with CRSwNP who were awaiting FESS in a district general hospital. We screened electronic records for eosinophil levels, previous asthma diagnosis, symptoms, and medical treatment.
RESULTS: Of the 709 patients on the otolaryngology waiting list, 123 patients with CRSwNP were awaiting FESS. Of those patients, 74 had previous eosinophilia (serum eosinophil count ≥ 0.3 x109/L), 32% were female, and their mean age was 53.5 years (SD 15 years). Of those 74 patients, 36 had a preexisting diagnosis of asthma, of whom 61% were at step 4 or 5 of the Global Initiative for Asthma guidelines, with 18% receiving 2 or more courses of oral steroids in the previous 12 months, 41% unknown to local asthma services, and 27% receiving biologic therapy for asthma. In addition, of those with eosinophilia with no previous asthma diagnosis who were awaiting FESS for nasal polyps (38 of 74), 26% had documented symptoms of breathlessness or wheeze.
CONCLUSION: We have identified patients with CRSwNP awaiting nasal polyp surgery who have eosinophillic asthma that may benefit from treatment optimization and review in a severe asthma service. Proactive identification of patients with severe asthma and comorbid CRSwNP who are currently awaiting FESS may widen access to asthma optimization and biologic medications.