Survey finds chronic rhinosinusitis common, burdensome

Results from a large cross-sectional survey of adults who meet diagnostic symptom  criteria for chronic rhinosinusitis reveal that most report suffering significant symptoms, high rates of physician visits, and dissatisfaction with current intranasal steroid sprays.

“Chronic rhinosinusitis is common, it’s severe, and people are seeking a lot of medical care,” said in an interview at the annual meeting of the American Academy of Allergy, Asthma, and Immunology, adding “It’s causing a lot of disruption in their lives, and they’re not satisfied with currently available intranasal steroids.”

While chronic rhinosinusitis (CRS)  has been linked to increased use of health care and antibiotics, most US epidemiologic data on the condition comes from administrative health claims databases. “Those are subject to their own limitations. For example, in claims data you get coding bias because it’s also used for reimbursement.”

In an effort to better characterize the prevalence and burden of illness in adults with symptoms of CRS, doctors  conducted a population-based survey of 10,336 US adults drawn from a representative general panel of 4.3 million.

They recruited participants via websites, email, phone, online, communities, and social networks and collected information about nasal symptoms, frequency, duration and severity/bother of nasal symptoms and health care use and treatments.

The researchers found that almost 12 percent of survey respondents self-reported symptoms that met diagnostics criteria for CRS. Of these, 63.5 percent were classified as having severe CRS without known nasal polyps (CRSsNP, and 9.6 percent had CRS with known nasal polyps (CRSwNP). In addition, 87-99 percent of patients reported seeing a physician for their symptoms and/or taking a prescription medicine for their CRS symptoms in the past year.

In fact, 60 percent of CRSwNP patients, 58 percent of severe CRSsNP patients, and 33 percent of moderate CRSsNP patients said they made more than five physician visits in the past year for nose and sinus symptoms.

The frequency of key CRS symptoms was similar in patients with and without nasal polyps, except that those with severe CRSsNP reported higher rates of facial pain/pressure (in the range of 60-65 percent) and loss of smell/taste (46-56 percent). The most frequently reported core symptoms were nasal congestion (94-97 percent) and drainage (89-92 percent).

Despite currently available treatment options, up to 46 percent of CRS patients reported that they remain “extremely” affected by symptoms, and 79 percent of all CRS patients expressed concern about flare-ups.

In addition, a large proportion of respondents expressed frustration with the inadequate symptom relief produced by their current intranasal corticosteroid (87 percent of CRSwNP patients, 86 percent of severe CRSsNP patients, and 63 percent of moderate CRSsNP patients).

The findings indicate a role for more and/or improved treatment options to meet the needs of this patient population. “People who have CRS have it pretty bad,” he said, and “Very few people are not seeking a lot of medical care for their symptoms.”