Ethan J. Han BS, Christine M. Liu BS, Jakob L. Fischer MD, Jess C. Mace MPH, CCRP, Karolin Markarian BS, Jeremiah A. Alt MD, PhD, Todd E. Bodner PhD, Naweed I. Chowdhury MD, MPH, Patricia H. Eshaghian MD, Yuqing A. Gao MD, Anne E. Getz MD, Peter H. Hwang MD, Ashoke Khanwalkar MD, Adam J. Kimple MD, PhD, Jivianne T. Lee MD, Douglas A. Li MD, Meghan Norris PA, Jayakar V. Nayak MD, PhD, Cameran Owens PA, Zara M. Patel MD, Katie Poch BS, Rodney J. Schlosser MD, Kristine A. Smith MD, Timothy L. Smith MD, MPH, Zachary M. Soler MD, MSc, Jeffrey D. Suh MD, Grant A. Turner MD, Marilene B. Wang MD, Jennifer L. Taylor-Cousar MD, MSCS, Milene T. Saavedra MD, Daniel M. Beswick MD
{"title":"Impact of sociodemographic status and sex on chronic rhinosinusitis and olfaction in people with cystic fibrosis","authors":"Ethan J. Han BS, Christine M. Liu BS, Jakob L. Fischer MD, Jess C. Mace MPH, CCRP, Karolin Markarian BS, Jeremiah A. Alt MD, PhD, Todd E. Bodner PhD, Naweed I. Chowdhury MD, MPH, Patricia H. Eshaghian MD, Yuqing A. Gao MD, Anne E. Getz MD, Peter H. Hwang MD, Ashoke Khanwalkar MD, Adam J. Kimple MD, PhD, Jivianne T. Lee MD, Douglas A. Li MD, Meghan Norris PA, Jayakar V. Nayak MD, PhD, Cameran Owens PA, Zara M. Patel MD, Katie Poch BS, Rodney J. Schlosser MD, Kristine A. Smith MD, Timothy L. Smith MD, MPH, Zachary M. Soler MD, MSc, Jeffrey D. Suh MD, Grant A. Turner MD, Marilene B. Wang MD, Jennifer L. Taylor-Cousar MD, MSCS, Milene T. Saavedra MD, Daniel M. Beswick MD","doi":"10.1002/alr.23402","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>β</i> = ‒4.09, 95% confidence interval [CI] [‒6.08, ‒2.11], <i>p</i> < 0.001), female sex (<i>β</i> = ‒2.14, 95% CI [‒4.11, ‒0.17], <i>p</i> = 0.034), and increasing age (<i>β</i> = ‒0.14, 95% CI [‒0.22, ‒0.05], <i>p</i> = 0.003) were associated with lower/better endoscopy scores. Private health insurance (<i>β</i> = 17.76, 95% CI [5.20, 30.32], <i>p</i> = 0.006) and >16 educational years (<i>β</i> = 13.50, 95% CI [2.21, 24.80], <i>p</i> = 0.020) were associated with higher baseline percent predicted forced expiratory volume in one second (ppFEV<sub>1</sub>). Medicaid/Medicare insurance was associated with worse endoscopy scores, CFQ-R respiratory scores, and ppFEV<sub>1</sub> (all <i>p</i> < 0.017), and Hispanic/Latino ethnicity was associated with worse SNOT-22 scores (<i>p</i> = 0.047), prior to adjustment for other cofactors. No other SDS factors were associated with SNOT-22, QOD-NS, or SIT scores.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Clinical Trials</h3>\n \n <p>NCT04469439</p>\n </section>\n </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"14 11","pages":"1700-1713"},"PeriodicalIF":7.2000,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530317/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Forum of Allergy & Rhinology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/alr.23402","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
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.
期刊介绍：
International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy.
International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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