(1211) Association Between Autoimmune Diseases and Chronic Rhinosinusitis Phenotypes: A Nationwide Cohort Study

Introduction: Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory condition of the paranasal sinuses, clinically categorized as CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP). Emerging evidence suggests a potential association between autoimmune diseases and CRS. The objective of this study is to examine the relationship between autoimmune diseases and CRS phenotypes using a nationwide electronic health record database.

Methods: This is a retrospective cohort study using Epic Cosmos database. Patients with documented diagnoses of autoimmune diseases were identified using structured ICD-10 queries including: Inflammatory Bowel Disease, Rheumatoid Arthritis, Sarcoidosis, Psoriasis, Ankylosing Spondylitis, Systemic Lupus Erythematosus, Sjögren Syndrome, Scleroderma, Other Autoimmune Diseases. The primary outcomes were the diagnosis with CRSsNP or CRSwNP.

Results: A total of 96,938 patients with autoimmune diseases were identified through Epic Cosmos. Among them, the overall prevalence of chronic sinusitis without nasal polyps was 5.5% whereas chronic sinusitis with nasal polyposis was identified in 0.51% of patients. When stratified by gender, females had a 7.22% prevalence of CRSsNP compared to 5.59% in males whereas males had a higher prevalence of CRSwNP (0.81% vs 0.59%). The calculated relative risk for CRSsNP in patients with autoimmune disease compared to those without autoimmune conditions was 0.959 (95% Confidence Interval: [0.904 , 1.017]). Sjögren syndrome (RR = 1.77, CI: 1.61–1.95) and ankylosing spondylitis (RR = 1.44, CI: 1.29–1.60) were associated with a significantly increased risk of chronic sinusitis compared to the non-autoimmune population and both had the highest prevalence of CRSsNP patients with 9.1% and 7.4% respectively. However, patients with autoimmune disorders were found to have lower risk of CRSwNP (RR=0.68, CI: 0.34-0.89)

Conclusions: While autoimmune disease in general may not confer increased overall risk for chronic sinusitis, specific autoimmune conditions may be more strongly associated with CRSsNP and warrant further investigation.