The prevalence of aspirin sensitivity and asthma in allergic fungal rhinosinusitis: a national case-control study

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Objectives: Chronic rhinosinusitis (CRS) affects 11% of the population and can be associated with significant morbidity. Allergic fungal rhinosinusitis (AFRS) is a subgroup of CRS characterised by high recurrence rates which can be difficult to diagnose and treat. Early recognition may help optimise treatment. Others with severe forms of CRS include patients with asthma who are more likely to have nasal polyps and may have aspirin sensitivity, exacerbating their symptoms. The aim of this analysis is to determine the prevalence of aspirin-sensitivity and asthma in CRS sub-types including AFRS.   Methods: Data for this analysis was taken from the UK Chronic Rhinosinusitis Epidemiology Study (CRES) which consists of a study-specific self-reported questionnaire about environmental, medical and socio-economic factors and incorporates the SF-36 and SNOT-22 questionnaires. Subjects were recruited from secondary and tertiary care clinics in Ear, Nose and Throat departments from 30 centres across the UK.  

Results: A total of 1,470 questionnaires were returned; controls 221, CRS without polyps 553 CRS with polyps 651, AFRS 45. The prevalence of self- reported aspirin sensitivity was 2.26% in controls, 3.25% in CRS without polyps 9.61% in CRS with nasal polyps and 40% in AFRS. The prevalence of asthma was 9.95%, 21.16%, 46.9% and 73.3% respectively. Odds ratio for aspirin sensitivity amongst those with AFRS 28.8 (9.9,83.8) p<0.000.

Conclusions: Aspirin sensitivity and asthma prevalence are higher amongst those with polypoid disease and may be factors by which these patients can be identified. Aspirin desensitisation and reduction of dietary salicylate may be a therapeutic consideration for such patients. Combined management with ENT, Respiratory Medicine and Allergy specialists may be beneficial for patients with complex disease. 

This study has been conducted by and is presented on behalf of the CRES Group.

Original languageEnglish
Title of host publicationBritish Society of Allergy & Clinical Immunology Annual Meeting Abstracts
Pages21
Number of pages1
Publication statusPublished - 2015

Cite this