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Liu CM, Overdevest JB, Zemke AC, Mace JC, Kimple AJ, Stapleton AL, Gudis DA, Smith TL, Taylor-Cousar JL, Beswick DM. In Response to Predictors of Sinonasal Improvement After Highly Effective Modulator Therapy in Adults with Cystic Fibrosis. Laryngoscope 2024; 134:E39-E40. [PMID: 39540572 DOI: 10.1002/lary.31597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 11/16/2024]
Affiliation(s)
- Christine M Liu
- Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, USA
| | - Jonathan B Overdevest
- Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, USA
| | - Anna C Zemke
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jess C Mace
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Adam J Kimple
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Charlotte, North Carolina, USA
| | - Amanda L Stapleton
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, USA
| | - Timothy L Smith
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Daniel M Beswick
- Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, USA
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Han EJ, Liu CM, Fischer JL, Mace JC, Markarian K, Alt JA, Bodner TE, Chowdhury NI, Eshaghian PH, Gao YA, Getz AE, Hwang PH, Khanwalkar A, Kimple AJ, Lee JT, Li DA, Norris M, Nayak JV, Owens C, Patel ZM, Poch K, Schlosser RJ, Smith KA, Smith TL, Soler ZM, Suh JD, Turner GA, Wang MB, Taylor-Cousar JL, Saavedra MT, Beswick DM. Impact of sociodemographic status and sex on chronic rhinosinusitis and olfaction in people with cystic fibrosis. Int Forum Allergy Rhinol 2024; 14:1700-1713. [PMID: 38967583 PMCID: PMC11530317 DOI: 10.1002/alr.23402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/19/2024] [Accepted: 06/23/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Sociodemographic status (SDS) including race/ethnicity and socioeconomic status as approximated by education, income, and insurance status impact pulmonary disease in people with cystic fibrosis (PwCF). The relationship between SDS and chronic rhinosinusitis (CRS) remains understudied. METHODS In a prospective, multi-institutional study, adult PwCF completed the 22-Question SinoNasal Outcome Test (SNOT-22), Smell Identification Test (SIT), Questionnaire of Olfactory Disorder Negative Statements (QOD-NS), and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Lund-Kennedy scores, sinus computed tomography, and clinical data were collected. Data were analyzed across race/ethnicity, sex, and socioeconomic factors using multivariate regression. RESULTS Seventy-three PwCF participated with a mean age of 34.7 ± 10.9 years and 49 (67.1%) were female. Linear regression identified that elexacaftor/tezacaftor/ivacaftor (ETI) use (β = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], p < 0.001), female sex (β = ‒2.14, 95% CI [‒4.11, ‒0.17], p = 0.034), and increasing age (β = ‒0.14, 95% CI [‒0.22, ‒0.05], p = 0.003) were associated with lower/better endoscopy scores. Private health insurance (β = 17.76, 95% CI [5.20, 30.32], p = 0.006) and >16 educational years (β = 13.50, 95% CI [2.21, 24.80], p = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV1). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ-R respiratory scores, and ppFEV1 (all p < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT-22 scores (p = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT-22, QOD-NS, or SIT scores. CONCLUSIONS Differences in objective measures of CRS severity exist among PwCF related to sex, age, and ETI use. Variant status and race did not influence patient-reported CRS severity measures or olfaction in this study. Understanding how these factors impact response to treatment may improve care disparities among PwCF. CLINICAL TRIALS NCT04469439.
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Affiliation(s)
- Ethan J. Han
- University of California, Los Angeles, Department of Head and Neck Surgery
| | - Christine M. Liu
- University of California, Los Angeles, Department of Head and Neck Surgery
| | - Jakob L. Fischer
- University of California, Los Angeles, Department of Head and Neck Surgery
| | - Jess C. Mace
- Oregon Health Sciences University, Department of Otolaryngology-Head and Neck Surgery
| | - Karolin Markarian
- University of California, Los Angeles, CTSI, David Geffen School of Medicine
| | - Jeremiah A. Alt
- University of Utah, Department of Otolaryngology-Head and Neck Surgery
| | | | - Naweed I. Chowdhury
- Vanderbilt University Medical Center, Department of Otolaryngology-Head and Neck Surgery
| | | | - Yuqing A. Gao
- University of California, Los Angeles, Department of Pulmonary Medicine
| | - Anne E. Getz
- University of Colorado, Department of Otolaryngology-Head and Neck Surgery
| | - Peter H. Hwang
- Stanford University, Department of Otolaryngology-Head and Neck Surgery
| | - Ashoke Khanwalkar
- University of Colorado, Department of Otolaryngology-Head and Neck Surgery
| | - Adam J. Kimple
- University of North Carolina, Department of Otolaryngology-Head and Neck Surgery
| | - Jivianne T. Lee
- University of California, Los Angeles, Department of Head and Neck Surgery
| | - Douglas A. Li
- University of California, Los Angeles, Department of Pulmonary Medicine
| | - Meghan Norris
- University of North Carolina, Department of Otolaryngology-Head and Neck Surgery
| | - Jayakar V. Nayak
- Stanford University, Department of Otolaryngology-Head and Neck Surgery
| | - Cameran Owens
- University of North Carolina, Department of Otolaryngology-Head and Neck Surgery
| | - Zara M. Patel
- Stanford University, Department of Otolaryngology-Head and Neck Surgery
| | - Katie Poch
- National Jewish Health, Department of Medicine
| | - Rodney J. Schlosser
- Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery
| | - Kristine A. Smith
- University of Utah, Department of Otolaryngology-Head and Neck Surgery
| | - Timothy L. Smith
- Oregon Health Sciences University, Department of Otolaryngology-Head and Neck Surgery
| | - Zachary M. Soler
- Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery
| | - Jeffrey D. Suh
- University of California, Los Angeles, Department of Head and Neck Surgery
| | - Grant A. Turner
- University of California, Los Angeles, Department of Pulmonary Medicine
| | - Marilene B. Wang
- University of California, Los Angeles, Department of Head and Neck Surgery
| | | | - Milene T. Saavedra
- Medical University of South Carolina, Department of Otolaryngology-Head and Neck Surgery
| | - Daniel M. Beswick
- University of California, Los Angeles, Department of Head and Neck Surgery
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