Aim: To compare oral corticosteroid (OCS) burden and healthcare resource utilization (HCRU) in patients with chronic rhinosinusitis with nasal polyps undergoing functional endoscopic sinus surgery (FESS; intervention) versus not undergoing FESS. Materials 2011–2021). Groups were propensity score (PS) matched to adjust for confounding. OCS burden (cumulative dose in mg prednisone equivalents) and HCRU were assessed during baseline (365 days pre-index), intervention (days 0–44), and follow-up (days 45–365) ; costs during intervention and follow-up. Results: Before PS-matching, both groups had substantial comorbidity burden (>50% allergic rhinitis; >25% asthma) and over half of patients had used OCS (65% FESS vs 52% non-FESS; p < 0. 01). After PS-matching (n = 8909 per group), OCS cumulative dose during follow-up was 18% lower among FESS versus non-FESS patients (mean difference: -40 mg per patient 95% CI: -57, -23; p < 0. 01). Similar proportions of patients filled OCS prescriptions during follow-up (35% FESS, 36% non-FESS) and in these patients, OCS burden remained high (mean SD cumulative dose 521 786 vs 612 906 mg, respectively). Mean total healthcare costs per patient during the intervention period were 28, 832 (FESS) and 2537 (non-FESS), but similar during follow-up (15, 659 and 15, 926, respectively). HCRU was similar in follow-up, except more FESS patients visited an otolaryngologist (57% vs 32%, p < 0. 01). Conclusion: In US clinical practice, OCS burden in patients with chronic rhinosinusitis with nasal polyps was significantly lower but remained substantial following FESS, and HCRU and costs during follow-up were similar to matched patients without FESS.
Isaman et al. (Wed,) studied this question.