Comorbidities associated with eosinophilic chronic rhinosinusitis: A systematic review and meta‐analysis

Objective Eosinophilic chronic rhinosinusitis (ECRS) is a histological subtype of CRS that is generally recognised as being more difficult to manage. Patients with ECRS tend to have greater disease severity and poorer treatment outcomes after sinus surgery when compared with non‐ECRS patients. The h...

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Bibliographic Details
Published in:Clinical otolaryngology 2020-07, Vol.45 (4), p.574-583
Main Authors: McHugh, Tobial, Levin, Marc, Snidvongs, Kornkiat, Banglawala, Sarfaraz M., Sommer, Doron D.
Format: Article
Language:English
Subjects:
Allergic rhinitis
ASA sensitivity
Asthma
Atopy
Biomarkers
Brackets
Cost analysis
eosinophil
Eosinophilia
histology
Histopathology
immunoglobulin E
Leukocytes (eosinophilic)
Medical treatment
Meta-analysis
nasal polyps
Patients
Phenotypes
Polyps
recurrence
Rhinitis
Rhinosinusitis
Sinusitis
Surgery
Tissues
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Summary:Objective Eosinophilic chronic rhinosinusitis (ECRS) is a histological subtype of CRS that is generally recognised as being more difficult to manage. Patients with ECRS tend to have greater disease severity and poorer treatment outcomes after sinus surgery when compared with non‐ECRS patients. The histopathology and biomarker assessments of ECRS are often unavailable prior to surgery and may be impractical and costly to analyse. Thus, the primary objective of this study was to understand clinical comorbidities associated with ECRS. Design/Setting We searched three independent databases for articles that reported clinical CRS comorbidities associated with tissue eosinophilia. Data from studies with the same reported comorbidities were pooled, and a forest plot analysis was used to assess potential associations with four different conditions including allergic rhinitis, ASA sensitivity, asthma and atopy. The association between the phenotype of nasal polyps and ECRS was also quantified as a secondary objective. ECRS cut‐off levels were as defined by papers included. Main outcome/Results Eighteen articles were identified. The presence of nasal polyps (the first numbers in brackets represent odds ratios) (5.85, 95% CI [3.61, 9.49], P 
ISSN:1749-4478
1749-4486
DOI:10.1111/coa.13536