Prevalence of asthma, aspirin sensitivity and allergy in chronic rhinosinusitis: data from the UK National Chronic Rhinosinusitis Epidemiology Study

• Main Authors: Carl M. Philpott, Sally Erskine, Claire Hopkins, Nirmal Kumar, Shahram Anari, Naveed Kara, Sankalp Sunkaraneni, Jaydip Ray, Allan Clark, Andrew Wilson, On behalf of the CRES group, Carl Philpott, Alasdair Robertson, Shahzada Ahmed, Sean Carrie, Vishnu Sunkaraneni, Paul Jervis, Jaan Panesaar, Amir Farboud, Russell Cathcart, Robert Almeyda, Hisham Khalil, Peter Prinsley, Nicolas Mansell, Mahmoud Salam, Jonathan Hobson, Jane Woods, Emma Coombes
• Format: Article
• Language: English
• Published: BMC 2018-06-01
• Series: Respiratory Research
• Subjects: Rhinitis; Sinusitis; Rhinosinusitis; Quality of life; Epidemiology; Asthma
• Online Access: http://link.springer.com/article/10.1186/s12931-018-0823-y

Abstract Background Chronic rhinosinusitis (CRS) is a common disorder associated with other respiratory tract diseases such as asthma and inhalant allergy. However, the prevalence of these co-morbidities varies considerably in the existing medical literature and by phenotype of CRS studied. The study objective was to identify the prevalence of asthma, inhalant allergy and aspirin sensitivity in CRS patients referred to secondary care and establish any differences between CRS phenotypes. Methods All participants were diagnosed in secondary care according to international guidelines and invited to complete a questionnaire including details of co-morbidities and allergies. Data were analysed for differences between controls and CRS participants and between phenotypes using chi-squared tests. Results The final analysis included 1470 study participants: 221 controls, 553 CRS without nasal polyps (CRSsNPs), 651 CRS with nasal polyps (CRSwNPs) and 45 allergic fungal rhinosinusitis (AFRS). The prevalence of asthma was 9.95, 21.16, 46.9 and 73.3% respectively. The prevalence of self-reported confirmed inhalant allergy was 13.1, 20.3, 31.0 and 33.3% respectively; house dust mite allergy was significantly higher in CRSwNPs (16%) compared to CRSsNPs (9%, p < 0.001). The prevalence of self- reported aspirin sensitivity was 2.26, 3.25, 9.61 and 40% respectively. The odds ratio for aspirin sensitivity amongst those with AFRS was 28.8 (CIs 9.9, 83.8) p < 0.001. Conclusions The prevalence of asthma and allergy in CRS varies by phenoytype, with CRSwNPs and AFRS having a stronger association with both. Aspirin sensitivity has a highly significant association with AFRS. All of these comorbidities are significantly more prevalent than in non-CRS controls and strengthen the need for a more individualised approach to the combined airway.