Utilization patterns of systemic corticosteroid use for chronic rhinosinusitis

Abstract Objective: We sought to characterize the utilization pattern and factors associated with use of systemic corticosteroids for CRS. Methods: This was a cross-sectional study of 236 participants with CRS who were prospectively recruited. Participants reported the number of CRS-related oral corticosteroid courses taken in the last year. Baseline CRS symptomatology was measured using the 22-item Sinonasal Outcome Test (SNOT-22) and SNOT-22 sleep, nasal, otologic/facial pain and emotional subdomain scores. Clinical and demographic characteristics were also collected. Association was determined between patient characteristics and oral corticosteroid use in the last year for CRS. Results: Sleep (p = .026), nasal (p < .001) and otologic/facial pain (p = .022) SNOT-22 subdomain scores, and nasal polyps (p = .007) were associated with CRS-related oral corticosteroid use. In study participants without polyps, past CRS-related oral corticosteroid use was associated with sleep (adjusted OR = 1.56, 95%CI: 1.01–2.40, p = .043), otologic/facial pain (adjusted OR = 1.65, 95%CI: 1.09–2.51, p = .019) and nasal subdomain scores (adjusted OR = 1.59, 95%CI: 1.01–2.51, p = .047). In study participants with polyps, past CRS-related oral corticosteroid use was only associated with the nasal subdomain score (adjusted OR = 2.20, 95%CI: 1.40–3.45, p = .001). Conclusions: Past CRS-related oral corticosteroid use was associated with increased baseline severity of specific symptoms, which were different depending on the presence of polyps.

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