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CURRENT STANDARD OF CARE FOR UNCONTROLLED CRSwNP MAY NOT PROVIDE LONG-TERM BENEFITS1

Systemic corticosteroids2,3

  • A short course of oral corticosteroids may be beneficial for patients; however, the benefit is unlikely to persist
  • Side effects with long-term exposure may limit their potential as a chronic therapy

Surgery2,4-6

  • Surgery aims to remove nasal obstruction, improving sinus ventilation and access for topical therapies
  • Patients with recurrent chronic rhinosinusitis with nasal polyposis (CRSwNP) who need revision surgery express a predominant Type 2 inflammation phenotype (with increased IL-5, eosinophilic cationic protein, total IgE, and IgE specific to Staphylococcus aureus enterotoxin)
  • Revision surgery is often required, primarily in patients with comorbidities

Patients with Type 2 comorbidity
require significantly more
frequent revision surgery7,a

In patients with CRSwNP, a UK study found8:

57%

had previous endoscopic
nasal polypectomy

of which

46%

had more than
1 operation

CRSwNP patients had a mean number of 3.3 previous surgeries per patient

Despite systemic corticosteroid treatment and revision surgery,
there remains an unmet medical need for patients with CRSwNP8

Download the measures of disease severity in CRSwNP reference tool

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a A study was conducted through electronic medical records at Northwestern University in Chicago, Illinois. CRSwNP, asthma, and AERD patients were identified. The following demographic and clinical features were characterized: sex, atopy, and sinus disease severity.

AERD, aspirin-exacerbated respiratory disease.

References: 1. Mendelsohn D, Jeremic G, Wright ED, Rotenberg BW. Revision rates after endoscopic sinus surgery: a recurrence analysis. Ann Otol Rhinol Laryngol. 2011;120(3):162-166. 2. Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(suppl 29):1-464. 3. Head K, Chong LY, Hopkins C, Philpott C, Burton MJ, Schilder AGM. Short-course oral steroids alone for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016;4:CD011991. doi:10.1002/14651858.CD011991.pub2 4. Bachert C, Pawankar R, Zhang L, et al. ICON: chronic rhinosinusitis. World Allergy Organ J. 2014;7(1):25. doi:10.1186/1939-4551-7-25 5. Vaidyanathan S, Barnes M, Williamson P, Hopkinson P, Donnan PT, Lipworth B. Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med. 2011;154(5):293-302. 6. Van Zele T, Holtappels G, Gevaert P, Bachert C. Differences in initial immunoprofiles between recurrent and nonrecurrent chronic rhinosinusitis with nasal polyps. Am J Rhinol Allergy. 2014;28(3):192-198. 7. Stevens WW, Peters AT, Hirsch AG, et al. Clinical characteristics of patients with chronic rhinosinusitis with nasal polyps, asthma, and aspirin-exacerbated respiratory disease. J Allergy Clin lmmunol Pract. 2017;5(4):1061-1070.e3. 8. Philpott C, Hopkins C, Erskine S, et al. The burden of revision sinonasal surgery in the UK—data from the Chronic Rhinosinusitis Epidemiology Study (CRES): a cross-sectional study. BMJ Open. 2015;5:e006680. doi:10.1136/bmjopen-2014-006680