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Utilization of Corticosteroid Delivery Systems for Treatment of Nasal Polyposis - Episode 2

Comorbidities with Chronic Rhinosinusitis

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Andrew White, MD, and Dareen Siri, MD, FAAAAI, FACAAI, discuss the comorbidities chronic rhinosinusitis with nasal polyps (CRSwNP) can be associated with.

Anju Peters, MD: Chronic rhinosinusitis can be associated with more comorbidities. Would you like to talk to us about that?

Andrew White, MD: A couple ways to think about the comorbidities, there's the comorbidities that just come along with the symptoms that the patients experience, but then the other like diseases that can travel with it. Naveen mentioned a few things. Some of the comorbidities would be asthma. It's common to have asthma as the extent of the sinus disease and the polyp disease worsens. It's a lot more likely for those patients to have asthma. We see those things travel together quite a bit. As allergist, we look a lot for allergies. We do find allergic rhinitis as well, with that. And then something I'm interested in, and then maybe we'll talk about it later, is the allergic reactions that seem to come along with NSAIDs. And those pain reliever class of medications, in a percentage of patients with polyps will trigger bad asthma, bad rhinitis symptoms, patients can't tolerate taking those medications. And that's another big morbidity that is associated with this condition. Other potential comorbidities like having antibody deficiencies and immune deficiencies that sometimes travels with these patients with greater frequency. They may be the patients that are not just having a lot of daily symptoms, but lots of exacerbations related to infection. And then the other things that I would put in this category of comorbidities might be, you know, a lot of the problems that happen because of having the disease. Disrupted sleep or even sleep apnea. And patients can have a lot of morbidity related to that, therefore, maybe directly related to their disease. Problems with fatigue and mood can certainly travel in this disease as well. Those would be the big things I think of, I probably missed a few others that if someone else wants to jump in and chime in, that would be great.

Anju Peters, MD: Would any of you guys have anything to add in, Dareen or Naveen?

Dareen Siri, MD, FAAAAI, FACAAI: They've done a great job discussing, you know, certainly the overview, the comorbidities. As a society - underestimate the fact that there are billions and billions of dollars being spent on these patients. And of course, we see so much of them in our clinics. With the recognition, I almost call this you know, the last 5 to 10 years, the sinus age. Because now we have treatments for this disease for those patients who just keep coming back to our clinic who are frustrated. It's underestimated as a disease, billions of dollars being spent, of course, and certainly, we have a large role in terms of trying to recognize these patients.

Anju Peters, MD: I agree. There's huge disease burden of this, of chronic rhinosinusitis.

Transcript edited for clarity