(1213) Atopic Versus Non-Atopic Chronic Rhinosinusitis With Nasal Polyps: Comparative Analysis of Outcomes

Introduction: The role of atopy in the pathogenesis and outcomes of chronic rhinosinusitis with nasal polyps (CRSwNP) remains unclear. This study aims to evaluate clinical characteristics and outcomes in atopic versus non-atopic CRSwNP patients.

Methods: We retrospectively identified 301 adult patients (≥18 years) with CRSwNP seen at Montefiore Medical Center (Bronx, NY) between 1/2021-11/2025 and who underwent skin prick testing (SPT) to aeroallergens. Those with ≥1 positive SPT were defined “atopic”. Those with all negative SPT were “non-atopic”. Data was collected through chart review.

Results: Of 301 patients, 229 (76%) were atopic and 72 (24%) non-atopic. Both groups had similar age (52±14 years vs 53±16years, p>0.5), with similar female proportions (54.8% vs 52.8%, p=0.76), but with higher Hispanic ethnicity rate in the atopic group (46.3% vs 30.6%, p=0.019). The frequencies of endoscopic sinus surgery (ESS) (61.6% vs 58.3%, p = 0.72) and treatment with biologics (38.3% vs 33.3%, p=0.53) were similar between atopic and non-atopic patients. Non-atopic individuals had higher rates and odds than atopic patients to have NP post-ESS at 3-6 months (9/29, 31% vs 16/109, 14.7%, OR=2.97, 95%CI: 1.06-8.28, p=0.03) and 6-12 months (10/19, 52.6% vs 19/93, 20.4%, OR=5.22, 95% CI: 1.67-16.34, p=0.005). No differences were found based on atopy for NP persistence in patients receiving biologics.

Conclusions: Despite similar surgical and biologic treatment patterns, non-atopic CRSwNP patients had significantly higher rates and odds of postoperative NP persistence at 3-6 and 6-12 months. Prospective studies are needed to evaluate the role of atopy in post-ESS NP recurrence.