2f:I[703058,["/_next/static/immutable/chunks/2esyeua7r8hxb.js","/_next/static/immutable/chunks/43wzqu_q6b8co.js","/_next/static/immutable/chunks/02igegklyi312.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/3d54cr_x61503.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/41sb2pnxui1_7.js","/_next/static/immutable/chunks/0z5fu495o1bws.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T73c,We aim to highlight recent advancements on the evolving chronic rhinosinusitis (CRS) phenotype: acute exacerbations of chronic rhinosinusitis (AECRS). We focused on studies that expanded the current understanding of its pathophysiology, patient characteristics, and disease burden. Defining AECRS has been a topic of discussion for many years. A recent regulatory definition of AECRS in the literature incorporates a > 3 day requirement of worsened symptoms and an escalation of treatment. It is important not to rely on patient-reported rescue medication frequency as it was recently demonstrated these are only obtained for 1/3 of reported AECRS episodes. The pathophysiology behind AECRS is still being evaluated but it appears irritants such as viral insult to the sinonasal microbiome can create a dysbiosis and worsens host immune system breakdown, facilitating a subsequent bacterial infection. Many studies are using loose definitions of AECRS because no formal definition has existed until recently. Clinical trials and other studies are relying on patient-reported illnesses, CRS-related antibiotics, and CRS-related corticosteroids to determine an episode of AECRS. Formally defining AECRS is vital in order to conduct future literature on its etiology and clinical outcomes so results may be translatable. Additionally, our review demonstrates that CRS patients with asthma and/or concomitant allergic rhinitis appear to be at an increased risk for developing AECRS and future research should continue to investigate their interplay. Many patients are being overprescribed antibiotics and corticosteroids for reported AECRS episodes. This increases total healthcare spending and increases the risk for adverse effects from corticosteroids and antibiotic resistance. Future research should investigate methods to mitigate this practice.31:T932,Abstract Purpose of Review We aim to highlight recent advancements on the evolving chronic rhinosinusitis (CRS) phenotype: acute exacerbations of chronic rhinosinusitis (AECRS). We focused on studies that expanded the current understanding of its pathophysiology, patient characteristics, and disease burden. Recent Findings Defining AECRS has been a topic of discussion for many years. A recent regulatory definition of AECRS in the literature incorporates a > 3 day requirement of worsened symptoms and an escalation of treatment. It is important not to rely on patient-reported rescue medication frequency as it was recently demonstrated these are only obtained for 1/3 of reported AECRS episodes. The pathophysiology behind AECRS is still being evaluated but it appears irritants such as viral insult to the sinonasal microbiome can create a dysbiosis and worsens host immune system breakdown, facilitating a subsequent bacterial infection. Summary Many studies are using loose definitions of AECRS because no formal definition has existed until recently. Clinical trials and other studies are relying on patient-reported illnesses, CRS-related antibiotics, and CRS-related corticosteroids to determine an episode of AECRS. Formally defining AECRS is vital in order to conduct future literature on its etiology and clinical outcomes so results may be translatable. Additionally, our review demonstrates that CRS patients with asthma and/or concomitant allergic rhinitis appear to be at an increased risk for developing AECRS and future research should continue to investigate their interplay. Many patients are being overprescribed antibiotics and corticosteroids for reported AECRS episodes. This increases total healthcare spending and increases the risk for adverse effects from corticosteroids and antibiotic resistance. Future research should investigate methods to mitigate this practice. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Chronic Rhinosinusitis in Allergy: Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed Allergy papers on Chronic Rhinosinusitis (condition). Clinician-written summaries and practical action steps. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/Allergy/condition/Chronic%20Rhinosinusitis\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Allergy Hub\",\"item\":\"https://www.reachrx.ai/hub/Allergy\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"condition: Chronic Rhinosinusitis\",\"item\":\"https://www.reachrx.ai/hub/Allergy/condition/Chronic%20Rhinosinusitis\"}]}}"}}]],["$","$L2f",null,{"title":"Chronic Rhinosinusitis in Allergy Research","description":"Discover peer-reviewed Allergy research on Chronic Rhinosinusitis with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1016/j.anai.2026.08.024","pmid":"42692406","title":"Exhalation Delivery System with Fluticasone in Chronic Rhinosinusitis by Eosinophil, Asthma, and Allergy Status","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-09-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.08.024","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-13T06:21:54.267Z","updated_at":"2026-09-13T06:21:54.267Z","tags":[{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"brand","value":"Xhance","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"condition","value":"Eosinophilia","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"generic","value":"fluticasone propionate","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"modality","value":"Exhalation Delivery System","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"modality","value":"Intranasal Corticosteroid","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"sample_size","value":"n=547","value_numeric":547},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"study_design","value":"Randomized Controlled Trial (Pooled Subgroup Analysis)","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"warning","value":"Dose-specific subgroup results are not reported separately; pooled EDS-FLU doses (186 µg and 372 µg) are combined in the abstract's subgroup comparisons.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"warning","value":"The brand name 'Xhance' is assumed for EDS-FLU (fluticasone propionate exhalation delivery system); the paper does not explicitly name the brand.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"warning","value":"The paper does not distinguish between CRS with and without nasal polyps (CRSwNP vs CRSsNP), which is a clinically important distinction that may affect generalizability.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.08.024","tag_type":"warning","value":"This is a subgroup analysis of two RCTs (ReOpen1, ReOpen2); randomization was not stratified by the subgroups examined, so treatment-by-subgroup interaction results should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"This pooled subgroup analysis of the ReOpen1 and ReOpen2 RCTs (N=547) evaluated whether baseline blood eosinophil count (0–299 vs ≥300 cells/µL), comorbid asthma, or environmental allergy modified the response to EDS-FLU (186 µg or 372 µg twice daily) vs EDS-placebo over 24 weeks in adults with CRS.","key_result":"EDS-FLU significantly improved composite symptom scores vs placebo at week 12 across all subgroups (all P<0.01): asthma (−2.12 vs −1.36), no asthma (−2.40 vs −1.52), allergy (−2.12 vs −1.24), no allergy (−2.37 vs −1.60), EOS 0–299 cells/µL (−2.11 vs −1.56), and EOS ≥300 cells/µL (−2.48 vs −1.36); SNOT-22 and PGIC results were consistent, with no significant treatment-by-subgroup interaction.","limitations":"- Subgroup analysis was post hoc and not pre-specified for primary inference, limiting causal conclusions.\n- Eosinophil and comorbidity subgroups were defined by self-report or a single blood draw, which may not reflect true endotype.\n- Authors explicitly note further investigation is warranted, suggesting underpowering within individual subgroups.","practice_takeaway":"Clinicians can expect meaningful symptom benefit from EDS-FLU in CRS patients regardless of whether they have comorbid asthma, environmental allergy, or elevated blood eosinophils—endotype profiling should not delay or withhold this treatment. Both doses were effective, so choice may be guided by tolerability and formulary access."}},{"doi":"10.1016/j.jaci.2026.04.011","pmid":null,"title":"The Editors’ Choice","journal_title":"Journal of Allergy and Clinical Immunology","journal_issn":"0091-6749","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaci.2026.04.011","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:34.477Z","updated_at":"2026-06-16T13:54:29.328Z","tags":[{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Eosinophilic Chronic Rhinosinusitis with Nasal Polyps","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Food Protein-Induced Enterocolitis Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Haploinsufficiency of A20","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"condition","value":"Inborn Errors of Immunity","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"generic","value":"thalidomide","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"COVID-19 Vaccine","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"IL-1 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"IL-4/IL-13 Receptor Antagonist","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"study_design","value":"Editors' Choice / Multi-Study Summary","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"Sample sizes reported are from individual highlighted studies; a single aggregate sample_size tag was not assigned due to the multi-study nature of this article.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The 'level of evidence' tag reflects the editorial/summary format and not the designs of the individual underlying studies, which range from prospective cohort to retrospective multicenter.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The paper provided contains only metadata (DOI, URL, journal name, and publication date). No abstract, methods, results, or conclusions were included. Structured summary fields, tags, and impact flags cannot be populated without source content. Please provide the full text or abstract for a complete extraction.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The paper provided contains only metadata (DOI, URL, journal name, and publication date) with no abstract, methods, results, or other substantive content. No summaries, tags, or evidence-based outputs can be reliably generated without the actual paper text. Please provide the full text or abstract for a complete extraction.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The provided source contains only bibliographic metadata (DOI, journal, publication date, and title 'The Editors' Choice') with no abstract, methods, results, or discussion text. No content-based extraction is possible. All summary fields and tags have been left null or empty to avoid speculation. Please provide the full paper text for a complete structured summary.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The provided source text contains only metadata (DOI, URL, journal name, and publication date) with no abstract, body text, or results. All summary fields have been set to null because no clinical content can be extracted or verified. Please provide the full paper text for a complete structured summary.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The provided source text contains only metadata (DOI, URL, journal name, publication date, and title). No abstract, methods, results, or discussion are included. All summary fields have been set to null because there is insufficient content to extract structured clinical information. Full-text access is required for a meaningful summary.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The study design label is non-standard given this is a multi-topic Editors' Choice editorial rather than a single study.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"The title 'The Editors' Choice' is a section label, not a specific study title — the actual paper content and topic are unknown from the provided information.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.011","tag_type":"warning","value":"This is an editorial summary of six distinct original articles; individual study-level data (full methods, complete results, effect sizes) are not available from this publisher page alone.","value_numeric":null}],"summaries":{"what_studied":"This Editors' Choice issue summarizes six original studies covering: squamous metaplasia in eCRSwNP (n=844 specimens), complement C3 in allergic rhinitis remodeling, PM2.5 and CRS inflammatory endotypes (n=634), gut microbiota in FPIES (n=56 children vs. 43 controls), HA20 clinical phenotypes (n=185 patients, 41 clinics, 7 countries), and COVID-19 vaccine immune memory in antibody-deficient IEI patients.","key_result":"Key findings across studies: (1) Squamous metaplasia was significantly more prevalent in eCRSwNP vs. non-eosinophilic CRS, and dupilumab reversed IL-4/IL-13–driven epithelial changes in vitro. (2) Complement C3/C3aR signaling drives macrophage lipid reprogramming and TGF-β1–mediated airway remodeling in allergic rhinitis. (3) Higher PM2.5 exposure linked to a mixed type 2/type 3 cytokine endotype (β=1.17, P<0.0001) in CRS patients. (4) FPIES children had reduced *Bifidobacterium* and Verrucomicrobiota vs. healthy controls. (5) HA20 clusters into age-dependent autoinflammatory (children) and autoimmune (adults) phenotypes; TNF/IL-1 inhibitors broadly effective. (6) Most IEI patients with antibody deficiency generated memory B and/or T cells after COVID-19 vaccination despite reduced neutralizing antibody titers.","limitations":"All six studies are summarized via an editorial overview rather than full-text reporting; individual study limitations (e.g., retrospective design for HA20, single-timepoint microbiota sampling in FPIES, and lack of long-term outcomes for IEI vaccine data) are not detailed here. The CRS/PM2.5 study relies on modeled rather than directly measured pollution exposure.","practice_takeaway":"Clinicians managing eCRSwNP should recognize squamous metaplasia as a common, biologic-reversible remodeling feature—dupilumab may address more than inflammation alone. For IEI patients, COVID-19 vaccination still builds memory B and T cell responses even when antibody titers are low, supporting continued booster strategies and assessment of cellular immunity in this group."}},{"doi":"10.1002/clt2.70177","pmid":"42173692","title":"Staphylococcus aureus\n and\n Staphylococcus lugdunensis\n Act in Concert to Disrupt the Nasal Epithelial Barrier","journal_title":"Clinical and Translational Allergy","journal_issn":"2045-7022","published_at":"2026-05-22T00:00:00.000Z","url":"https://doi.org/10.1002/clt2.70177","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-28T13:24:19.989Z","updated_at":"2026-05-28T13:24:19.989Z","tags":[{"paper_doi":"10.1002/clt2.70177","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"generic","value":"Staphylococcus aureus exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"generic","value":"Staphylococcus epidermidis exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"generic","value":"Staphylococcus lugdunensis exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"modality","value":"Microbial Exoproteins","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"sample_size","value":"n=22","value_numeric":22},{"paper_doi":"10.1002/clt2.70177","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"study_design","value":"In Vitro Experimental Study","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"warning","value":"Patient sex and age distributions are not specified in the abstract; the 'mixed' sex tag is an assumption based on typical CRS study populations.","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"warning","value":"The level of evidence (5) reflects an in vitro mechanistic study without a clinical comparator arm; some hierarchies may classify this differently.","value_numeric":null},{"paper_doi":"10.1002/clt2.70177","tag_type":"warning","value":"The study design is in vitro only; no clinical outcomes (e.g., symptom scores, treatment response) are reported, limiting direct clinical translation.","value_numeric":null}],"summaries":{"what_studied":"This in vitro study examined how exoproteins from *S. aureus*, *S. epidermidis*, and *S. lugdunensis* — isolated from the same CRS and control patients — affect nasal epithelial barrier function, cytotoxicity, and inflammation using primary human nasal epithelial cells (HNECs) cultured at air-liquid interface (ALI).","key_result":"15 of 22 *S. aureus* exoproteins significantly increased cytotoxicity, reduced TEER, and raised paracellular permeability (p < 0.05); *S. epidermidis* and *S. lugdunensis* exoproteins had mild or negligible barrier effects alone, but *S. lugdunensis* drove significantly higher IL-6, and correlation analysis showed *S. aureus* + *S. lugdunensis* from the same patient acted in concert to disrupt the barrier.","limitations":"- In vitro ALI model may not fully replicate the in vivo sinonasal environment or polymicrobial biofilm dynamics.\n- Small sample size (22 patients, 44 isolates) limits generalizability.\n- Exoproteins were tested at a single fixed concentration (20 µg/mL), so dose-response relationships are unknown.","practice_takeaway":"Clinicians managing recalcitrant CRS should be aware that co-colonization with *S. aureus* and *S. lugdunensis* may synergistically worsen mucosal barrier breakdown — not just *S. aureus* alone. This supports thorough microbiome profiling of sinonasal swabs in CRS patients, especially in refractory cases."}},{"doi":"10.1111/all.70332","pmid":"42011838","title":"Meta‐Analysis on the Harm of Systemic Glucocorticosteroids in Inflammatory Upper Airway Disease and Asthma: An EAACI Task Force","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-04-21T00:00:00.000Z","url":"https://doi.org/10.1111/all.70332","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:37.793Z","updated_at":"2026-05-09T13:22:37.793Z","tags":[{"paper_doi":"10.1111/all.70332","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"condition","value":"Chronic Rhinosinusitis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"Exact total sample size (N) was not reported in the abstract; the sample_size tag has been omitted.","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"Study scope is limited to inflammatory airway diseases; generalizability to other sGCS indications is uncertain.","value_numeric":null},{"paper_doi":"10.1111/all.70332","tag_type":"warning","value":"The 500 mg–1 g prednisolone-equivalent threshold is a pooled meta-analytic signal — individual patient risk may vary based on comorbidities, genetics, and concurrent medications.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis evaluated adverse effects (AEs) of systemic glucocorticosteroids (sGCS) in chronic inflammatory upper and lower airway diseases (rhinitis, rhinosinusitis, asthma), examining both short- and long-term risks and whether a dose-response relationship exists between daily/cumulative sGCS dosage and AE occurrence.","key_result":"Cumulative sGCS doses between 500 mg and 1 g prednisolone-equivalent significantly increased the risk of most AEs, with risk rising incrementally with higher doses — including risks from repeated short courses, not just long-term continuous use.","limitations":"The review focuses on airway diseases, so findings may not generalize to sGCS use in other conditions. Heterogeneity across included studies in dosing definitions and AE reporting may affect pooled estimates. The acceptable cumulative threshold remains empirically uncertain given variable individual susceptibility.","practice_takeaway":"Avoid cumulative sGCS exposure reaching 500 mg prednisolone-equivalent by prioritizing steroid-sparing therapies (e.g., biologics) early. Even repeated short courses carry meaningful harm — steroid stewardship should be applied rigorously in rhinitis, rhinosinusitis, and asthma management."}},{"doi":"10.1007/s11882-025-01239-0","pmid":"41420663","title":"Acute Exacerbations of Chronic Rhinosinusitis","journal_title":"Current Allergy and Asthma Reports","journal_issn":"1529-7322","published_at":"2025-12-20T00:00:00.000Z","url":"https://doi.org/10.1007/s11882-025-01239-0","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-24","doi":"10.1007/s11882-025-01239-0","days":"30","issn":"1529-7322","rank":"1","field":"Clinical Medicine","score":"19","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1007/s11882-025-01239-0","title":"Acute Exacerbations of Chronic Rhinosinusitis.","journal":"Current allergy and asthma reports","methods":"","results":"","abstract":"$30","keywords":["Acute","Antibiotics","Chronic rhinosinusitis","Corticosteroids","Exacerbation"],"pubmed_id":"41420663","conclusions":"","publication_date":"2025-12-20T00:00:00"},"crossref":{"DOI":"10.1007/s11882-025-01239-0","URL":"https://doi.org/10.1007/s11882-025-01239-0","ISSN":["1529-7322","1534-6315"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1007/s11882-025-01239-0.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1007/s11882-025-01239-0","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1007/s11882-025-01239-0.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Acute Exacerbations of Chronic Rhinosinusitis"],"author":[{"given":"Robert M.","family":"Frederick","sequence":"first","affiliation":[]},{"given":"Kent","family":"Lam","sequence":"additional","affiliation":[]},{"given":"Joseph K.","family":"Han","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,12]]},"member":"297","prefix":"10.1007","source":"Crossref","volume":"25","created":{"date-time":"2025-12-20T04:33:56Z","timestamp":1766205236000,"date-parts":[[2025,12,20]]},"indexed":{"date-time":"2025-12-20T06:25:55Z","timestamp":1766211955833,"date-parts":[[2025,12,20]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000,"date-parts":[[2025,12,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000,"date-parts":[[2025,12,20]]},"delay-in-days":19,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1007/s11882-025-01239-0"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"27 October 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":2,"value":"23 November 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":3,"value":"20 December 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"},"order":2,"value":"None."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights"},"order":3,"value":"This article does not contain any studies with human or animal subjects performed by any of the authors."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"},"order":4,"value":"The authors declare no competing interests."}],"deposited":{"date-time":"2025-12-20T04:33:57Z","timestamp":1766205237000,"date-parts":[[2025,12,20]]},"issn-type":[{"type":"print","value":"1529-7322"},{"type":"electronic","value":"1534-6315"}],"published":{"date-parts":[[2025,12]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.4193/Rhin23.415","key":"1239_CR1","year":"2024","issue":"3","author":"WJ Fokkens","volume":"62","first-page":"287","unstructured":"Fokkens WJ, De Corso E, Backer V, et al. 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Rescue medication fills occurred in only about one-third of patient‑reported AECRS episodes; patients with CRS and asthma and/or allergic rhinitis appear at higher risk, and antibiotics and corticosteroids are often overprescribed.","limitations":"Many included studies used loose or inconsistent AECRS definitions and proxies (patient‑reported illness, CRS‑related antibiotic/corticosteroid use), limiting comparability. The pathophysiology remains under active study and is not fully defined.","practice_takeaway":"When diagnosing AECRS, apply the >3‑day worsening plus treatment‑escalation criterion and avoid relying on rescue‑medication fills alone. Be cautious with routine antibiotics or corticosteroids, and recognize asthma/allergic rhinitis as risk markers."}}],"initialOffset":5,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"category","value":"Allergy"},{"tag_type":"condition","value":"Chronic Rhinosinusitis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Allergy","href":"/hub/Allergy"},{"name":"condition: Chronic Rhinosinusitis","metadata":{"type":"condition","value":"Chronic Rhinosinusitis"}}],"hrefConfig":{"basePath":"/hub/Allergy/papers","webViewQueryParams":{"hub_ctx":"category_tag","hub_category":"Allergy","hub_tag_type":"condition","hub_tag_value":"Chronic Rhinosinusitis"}}}]]

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