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Predictors of Sinonasal Improvement After Highly Effective Modulator Therapy in Adults with Cystic Fibrosis.
Beswick, Daniel M; Liu, Christine M; Overdevest, Jonathan B; Zemke, Anna; Khatiwada, Aastha; Gudis, David A; Miller, Jessa E; Kimple, Adam; Tervo, Jeremy P; DiMango, Emily; Goralski, Jennifer L; Keating, Claire; Senior, Brent; Stapleton, Amanda L; Eshaghian, Patricia H; Mace, Jess C; Markarian, Karolin; Alt, Jeremiah A; Bodner, Todd E; Chowdhury, Naweed I; Getz, Anne E; Hwang, Peter H; Khanwalker, Ashoke; 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; Saavedra, Milene T; Taylor Cousar, Jennifer L.
Afiliación
  • Beswick DM; Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
  • Liu CM; Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
  • Overdevest JB; Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, U.S.A.
  • Zemke A; Division of Pulmonary Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
  • Khatiwada A; Department of Biostatistics, National Jewish Health, Denver, Colorado, U.S.A.
  • Gudis DA; Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, U.S.A.
  • Miller JE; Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
  • Kimple A; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.
  • Tervo JP; Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, U.S.A.
  • DiMango E; Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University, New York, New York, U.S.A.
  • Goralski JL; Department of Pulmonary Medicine, University of North Carolina, Chapel Hill, North Carolina, U.S.A.
  • Keating C; Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University, New York, New York, U.S.A.
  • Senior B; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.
  • Stapleton AL; Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
  • Eshaghian PH; Department of Pulmonary Medicine, University of California, Los Angeles, California, U.S.A.
  • Mace JC; Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.
  • Markarian K; CTSI, David Geffen School of Medicine, University of California, Los Angeles, California, U.S.A.
  • Alt JA; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
  • Bodner TE; Department of Psychology, Portland State University, Portland, Oregon, U.S.A.
  • Chowdhury NI; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt Health, Nashville, Tennessee, U.S.A.
  • Getz AE; Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, U.S.A.
  • Hwang PH; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A.
  • Khanwalker A; Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, U.S.A.
  • Lee JT; Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
  • Li DA; Department of Pulmonary Medicine, University of California, Los Angeles, California, U.S.A.
  • Norris M; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.
  • Nayak JV; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A.
  • Owens C; Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, U.S.A.
  • Patel ZM; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A.
  • Poch K; Department of Medicine, National Jewish Health, Denver, Colorado, U.S.A.
  • Schlosser RJ; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Greenville, South Carolina, U.S.A.
  • Smith KA; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
  • Smith TL; Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.
  • Soler ZM; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
  • Suh JD; Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
  • Turner GA; Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.
  • Wang MB; Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
  • Saavedra MT; Department of Medicine, National Jewish Health, Denver, Colorado, U.S.A.
  • Taylor Cousar JL; Department of Medicine, National Jewish Health, Denver, Colorado, U.S.A.
Laryngoscope ; 134(9): 3965-3973, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38634358
ABSTRACT

OBJECTIVES:

The 22-question SinoNasal Outcome Test (SNOT-22) assesses chronic rhinosinusitis (CRS) severity. We aimed to identify predictors of SNOT-22 score improvement following highly effective modulator therapy (HEMT) initiation and to corroborate the SNOT-22 minimal clinically important difference (MCID) in adults with cystic fibrosis (CF).

METHODS:

Prospective observational data was pooled from four studies across 10 US centers investigating people with CF (PwCF) and CRS. Three studies evaluated HEMT's impact on CRS. For participants enrolled prior to HEMT initiation, SNOT-22 scores were obtained at baseline and after 3-6 months of HEMT. Multivariate regression identified predictors of improvement. Cronbach's alpha and four distribution-based methods were used to assess internal consistency and calculate the MCID of the SNOT-22.

RESULTS:

A total of 184 PwCF participated with mean baseline SNOT-22 scores ranging from 18.1 to 56.7. Cronbach's alpha was ≥0.90 across sites. Participants at sites with pre- and post-HEMT data reported improvement in SNOT-22 scores after initiating HEMT (all p < 0.05). Worse baseline SNOT-22 score (odds ratio (OR) 1.05, p < 0.001, 95% CI 1.02-1.08), F508del homozygosity (OR 4.30, p = 0.040, 95% CI 1.14-18.99), and absence of prior modulator therapy (OR 4.99, p = 0.017, 95% CI 1.39-20.11) were associated with greater SNOT-22 improvement. The mean MCID calculated via distribution-based methods was 8.5.

CONCLUSION:

Worse baseline sinonasal symptoms, F508del homozygosity, and absence of prior modulator therapy predicted greater improvement after HEMT initiation. The mean MCID for SNOT-22 in PwCF is 8.5 points, similar to non-CF individuals with CRS, and provides a threshold specifically for PwCF. The SNOT-22 has strong internal consistency in PwCF. LEVEL OF EVIDENCE 3 Laryngoscope, 1343965-3973, 2024.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sinusitis / Rinitis / Fibrosis Quística Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Laryngoscope Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sinusitis / Rinitis / Fibrosis Quística Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Laryngoscope Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos