Predictors of Sinonasal Improvement After Highly Effective Modulator Therapy in Adults with Cystic Fibrosis.

CFTR modulator therapy chronic rhinosinusitis cystic fibrosis elexacaftor/tezacaftor/ivacaftor minimal clinically important difference

Journal

The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378

Informations de publication

Date de publication:
18 Apr 2024
Historique:
revised: 04 03 2024
received: 22 12 2023
accepted: 25 03 2024
medline: 18 4 2024
pubmed: 18 4 2024
entrez: 18 4 2024
Statut: aheadofprint

Résumé

The 22-question SinoNasal Outcome Test (SNOT-22) assesses chronic rhinosinusitis (CRS) severity. We aimed to identify predictors of SNOT-22 score improvement following highly effective modulator therapy (HEMT) initiation and to corroborate the SNOT-22 minimal clinically important difference (MCID) in adults with cystic fibrosis (CF). Prospective observational data was pooled from four studies across 10 US centers investigating people with CF (PwCF) and CRS. Three studies evaluated HEMT's impact on CRS. For participants enrolled prior to HEMT initiation, SNOT-22 scores were obtained at baseline and after 3-6 months of HEMT. Multivariate regression identified predictors of improvement. Cronbach's alpha and four distribution-based methods were used to assess internal consistency and calculate the MCID of the SNOT-22. A total of 184 PwCF participated with mean baseline SNOT-22 scores ranging from 18.1 to 56.7. Cronbach's alpha was ≥0.90 across sites. Participants at sites with pre- and post-HEMT data reported improvement in SNOT-22 scores after initiating HEMT (all p < 0.05). Worse baseline SNOT-22 score (odds ratio (OR): 1.05, p < 0.001, 95% CI: 1.02-1.08), F508del homozygosity (OR: 4.30, p = 0.040, 95% CI: 1.14-18.99), and absence of prior modulator therapy (OR: 4.99, p = 0.017, 95% CI: 1.39-20.11) were associated with greater SNOT-22 improvement. The mean MCID calculated via distribution-based methods was 8.5. Worse baseline sinonasal symptoms, F508del homozygosity, and absence of prior modulator therapy predicted greater improvement after HEMT initiation. The mean MCID for SNOT-22 in PwCF is 8.5 points, similar to non-CF individuals with CRS, and provides a threshold specifically for PwCF. The SNOT-22 has strong internal consistency in PwCF. 3 Laryngoscope, 2024.

Identifiants

DOI: 10.1002/lary.31438 PMID: 38634358
pubmed: 38634358
doi: 10.1002/lary.31438
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIDCD NIH HHS
ID : R25DC020151
Pays : United States

Informations de copyright

© 2024 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.

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Auteurs

Daniel M Beswick (DM)

Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
ORCID: 0000-0001-8612-5442

Christine M Liu (CM)

Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
ORCID: 0000-0001-9985-4775

Jonathan B Overdevest (JB)

Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, U.S.A.
ORCID: 0000-0002-1152-2512

Anna Zemke (A)

Division of Pulmonary Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.

Aastha Khatiwada (A)

Department of Biostatistics, National Jewish Health, Denver, Colorado, U.S.A.

David A Gudis (DA)

Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, U.S.A.
ORCID: 0000-0002-1938-9349

Jessa E Miller (JE)

Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
ORCID: 0000-0001-9769-187X

Adam Kimple (A)

Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.

Jeremy P Tervo (JP)

Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, U.S.A.

Emily DiMango (E)

Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University, New York, New York, U.S.A.

Jennifer L Goralski (JL)

Department of Pulmonary Medicine, University of North Carolina, Chapel Hill, North Carolina, U.S.A.

Claire Keating (C)

Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University, New York, New York, U.S.A.

Brent Senior (B)

Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.

Amanda L Stapleton (AL)

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.

Patricia H Eshaghian (PH)

Department of Pulmonary Medicine, University of California, Los Angeles, California, U.S.A.

Jess C Mace (JC)

Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.

Karolin Markarian (K)

CTSI, David Geffen School of Medicine, University of California, Los Angeles, California, U.S.A.

Jeremiah A Alt (JA)

Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
ORCID: 0000-0003-0560-5028

Todd E Bodner (TE)

Department of Psychology, Portland State University, Portland, Oregon, U.S.A.

Naweed I Chowdhury (NI)

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt Health, Nashville, Tennessee, U.S.A.

Anne E Getz (AE)

Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, U.S.A.

Peter H Hwang (PH)

Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A.

Ashoke Khanwalker (A)

Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, U.S.A.

Jivianne T Lee (JT)

Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
ORCID: 0000-0002-0711-855X

Douglas A Li (DA)

Department of Pulmonary Medicine, University of California, Los Angeles, California, U.S.A.

Meghan Norris (M)

Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.

Jayakar V Nayak (JV)

Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A.
ORCID: 0000-0003-4454-0861

Cameran Owens (C)

Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, U.S.A.

Zara M Patel (ZM)

Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A.
ORCID: 0000-0003-2072-982X

Katie Poch (K)

Department of Medicine, National Jewish Health, Denver, Colorado, U.S.A.

Rodney J Schlosser (RJ)

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Greenville, South Carolina, U.S.A.

Kristine A Smith (KA)

Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.

Timothy L Smith (TL)

Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.
ORCID: 0000-0002-6424-7083

Zachary M Soler (ZM)

Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
ORCID: 0000-0002-4304-595X

Jeffrey D Suh (JD)

Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.

Grant A Turner (GA)

Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.

Marilene B Wang (MB)

Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.

Milene T Saavedra (MT)

Department of Medicine, National Jewish Health, Denver, Colorado, U.S.A.

Jennifer L Taylor Cousar (JL)

Department of Medicine, National Jewish Health, Denver, Colorado, U.S.A.
Department of Pediatrics, National Jewish Health, Denver, Colorado, U.S.A.

Classifications MeSH