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Patient perspectives on chronic rhinosinusitis in cystic fibrosis: Symptom prioritization in the era of highly effective modulator therapy.
Liu, Christine M; Han, Ethan J; Fischer, Jakob L; Mace, Jess C; Mattos, Jose L; Markarian, Karolin; Alt, Jeremiah A; Bodner, Todd E; Chowdhury, Naweed I; Eshaghian, Patricia H; Getz, Anne E; Hwang, Peter H; Khanwalkar, Ashoke; Kimple, Adam J; Lee, Jivianne T; Li, Douglas A; Norris, Meghan; Nayak, Jayakar V; Owens, Cameran; Patel, Zara M; Poch, Katie; Schlosser, Rodney J; Smith, Kristine A; Smith, Timothy L; Soler, Zachary M; Suh, Jeffrey D; Turner, Grant A; Wang, Marilene B; Taylor-Cousar, Jennifer L; Saavedra, Milene T; Beswick, Daniel M.
Afiliação
  • Liu CM; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
  • Han EJ; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
  • Fischer JL; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
  • Mace JC; Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon, USA.
  • Mattos JL; Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, University of Virginia, Charlottesville, Virginia, USA.
  • Markarian K; CTSI, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
  • Alt JA; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.
  • Bodner TE; Department of Psychology, Portland State University, Portland, Oregon, USA.
  • Chowdhury NI; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt Health, Nashville, Tennessee, USA.
  • Eshaghian PH; Department of Pulmonary Medicine, University of California, Los Angeles, California, USA.
  • Getz AE; Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.
  • Hwang PH; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA.
  • Khanwalkar A; Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.
  • Kimple AJ; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Lee JT; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
  • Li DA; Department of Pulmonary Medicine, University of California, Los Angeles, California, USA.
  • Norris M; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Nayak JV; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA.
  • Owens C; Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.
  • Patel ZM; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA.
  • Poch K; Department of Medicine, National Jewish Health, Denver, Colorado, USA.
  • Schlosser RJ; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Smith KA; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.
  • Smith TL; Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon, USA.
  • Soler ZM; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
  • Suh JD; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
  • Turner GA; Department of Pulmonary Medicine, University of California, Los Angeles, California, USA.
  • Wang MB; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA.
  • Taylor-Cousar JL; Department of Medicine, National Jewish Health, Denver, Colorado, USA.
  • Saavedra MT; Department of Pediatrics, National Jewish Health, Denver, Colorado, USA.
  • Beswick DM; Department of Medicine, National Jewish Health, Denver, Colorado, USA.
Int Forum Allergy Rhinol ; 14(8): 1282-1293, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38343143
ABSTRACT

BACKGROUND:

Chronic rhinosinusitis (CRS) is common in people with cystic fibrosis (PwCF). Rhinologic symptom prioritization and areas that influence CRS treatment choices, including pursuing endoscopic sinus surgery (ESS), remain understudied.

METHODS:

Adult PwCF + CRS were enrolled at eight centers into a prospective, observational study (2019-2023). Participants were administered the 22-SinoNasal Outcome Test (SNOT-22) survey and a modified SNOT-22 instrument examining symptom importance. We determined importance rankings for individual symptoms and SNOT-22 symptom importance subdomains in two sets of subgroups-those pursuing ESS versus continuing medical management (CMT), and those on elexacaftor/tezacaftor/ivacaftor (ETI) versus not on ETI.

RESULTS:

Among 69 participants, the highest priorities were nasal congestion (n = 48, 69.6% important), post-nasal discharge (32, 46.4%), facial pain (29, 43.3%), waking up tired (27, 39.1%), and fatigue (26, 37.7%). Those electing surgery (n = 23) prioritized sleep and psychological dysfunction symptoms compared to those pursuing CMT (n = 49) (sleep median score = 19.0 [interquartile range 12.0, 25.0] vs. 4.5 [0.0, 12.8]; p < 0.0001; psychological = 17.0 [7.0, 26.0] vs. 7.0 [0.0, 15.8]; p = 0.002). ETI users had comparable SNOT-22 total symptom importance scores to non-ETI users (p = 0.14). Non-ETI users (n = 34) showed a trend toward prioritizing sleep symptoms compared to ETI users (n = 35) (13.0 [2.8, 22.3] vs. 6.0 [2.0, 17.0]; p = 0.055).

CONCLUSIONS:

Nasal congestion and post-nasal discharge were top priorities reported by PwCF + CRS. Those electing surgery prioritized sleep and psychological symptoms, highlighting their importance in pre-operative discussions. Non-ETI users' prioritization of sleep improvement may highlight their unique disease impact and therapeutic needs; however, additional investigation is required.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrose Cística / Rinossinusite / Aminofenóis Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Humans Idioma: En Revista: Int Forum Allergy Rhinol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fibrose Cística / Rinossinusite / Aminofenóis Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Humans Idioma: En Revista: Int Forum Allergy Rhinol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos