Real‐world burden and treatment of chronic rhinosinusitis in Japan: A retrospective claims database analysis

• Published in: Laryngoscope investigative otolaryngology Vol. 8; no. 2; pp. 346 - 356
• Main Authors: Yoshikawa, Mamoru, Sunaga, Yoshinori, Koshiba, Ryuji, Inukai, Miho, Takeuchi, Makiko
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2023; Wiley
• Subjects: Allergy, Rhinology, and Immunology; Arthritis; Asthma; Comorbidity; corticosteroids; Disease; drug prescriptions; Drug therapy; Endoscopy; global burden of disease; Hospitalization; Inflammation; Japan; Original Research; Otolaryngology; Polyps; Prescription drugs; Rhinitis; Sinuses; Sinusitis; Steroids; Surgery; Tomography; Japan; drug prescriptions; sinusitis; corticosteroids; Japan; global burden of disease
• ISSN: 2378-8038; 2378-8038
• DOI: 10.1002/lio2.1027

Objectives Chronic rhinosinusitis (CRS) is a heterogeneous disease, which can be subdivided into CRS with (CRSwNP) or without (CRSsNP) nasal polyps. An intractable form of CRSwNP that is associated with an eosinophil‐dominant inflammatory cell infiltration (eosinophilic CRS) has become more prevalent in Japan. There is currently limited information on the burden of CRS in Japan and treatment approaches used in real‐world practice. Methods This retrospective, observational, comparative cohort study used information from the Japanese JMDC insurance claims database (study period April 1, 2015, to March 31, 2020). A CRS cohort was identified and matched with a control group without CRS. The primary objective was to clarify disease burden and treatment approaches by comparing comorbidities, healthcare resource utilization (HRU), and drug prescriptions in the CRS and non‐CRS groups. Results In total, 23,256 individuals with CRS (1762 with CRSwNP and 21,494 with CRSsNP) were matched with 23,256 controls. The mean age was 45 years and the majority of individuals were male (57%). Individuals with CRS had a higher disease burden than controls, with more frequent comorbidities (particularly, type 2 inflammatory disease [e.g., allergic rhinitis and asthma], and those caused by systemic corticosteroids [SCS]), and higher HRU (including outpatient visits, laboratory examinations and surgical procedures). Further, individuals with CRS were prescribed more medications, both for CRS (including SCS) and non‐CRS conditions, than controls. Conclusion In Japan, CRS is associated with a high disease burden, and multiple treatment approaches are used in affected individuals, including long‐term SCS, which is generally not recommended. Level of Evidence 3 The prevalence of chronic rhinosinusitis (CRS) is increasing in Japan, but there is limited information on CRS burden and real‐world treatment practices. This retrospective, comparative cohort study compared disease burden and treatment approaches in individuals with‐CRS and without‐CRS. Our results indicate that individuals with CRS have more frequent combordities (e.g., allergic rhinitis/asthma), higher healthcare resource utilization (outpatient visits and surgical procedures), and are prescribed more medications, including systemic corticosteroids, for both CRS and non‐CRS conditions. Our real‐world analysis suggests an unmet need for CRS treatment given the limitation of traditional therapies; additional agents are required to effectively and safely treat CRS.