Asthma and antibiotic use are linked to a higher risk of revision surgery in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). This finding is based on a real-world evidence (RWE) study published in February.
According to Juhani Aakko, Senior Data Scientist at Medaffcon, the study aimed to identify predictive factors for revision surgery in CRSwNP patients. Although these patients may benefit from endoscopic sinus surgery (ESS), some experience polyp recurrence, which increases the overall burden of the disease.
The study was published in the journal Clinical and Translational Allergy (CTA). The article highlights that the prevalence of CRSwNP is rising in Finland and other Nordic countries. CRSwNP is associated with morbidity and reduced quality of life, emphasizing the need for effective treatment options and prevention strategies.
Chronic rhinosinusitis (CRS) is an inflammatory disease of the nasal sinuses with various subtypes. Approximately 25–30% of CRS patients develop nasal polyps (NP), which are benign inflammatory growths on the mucosa of the nasal and sinus cavities.
The study showed that pre-existing asthma and antibiotic use were linked to a higher risk of revision surgery, particularly within three years after the initial surgery. Aging was found to have an inverse relationship with the likelihood of revision surgery.
“This study built on previous nasal polyp research. The aim was to understand why surgical treatment is effective for some patients but not for others by investigating contributing and risk factors,” Aakko explained.
Patients who underwent extensive surgery had the highest risk of revision surgery compared to those who had limited procedures. Oral corticosteroid (OCS) use was prevalent among CRSwNP patients, with those undergoing multiple revision surgeries accumulating a higher total OCS dose compared to those without revisions.
This nationwide population-based study included all adult patients in Finland diagnosed with CRSwNP who underwent ESS. The study involved 3,506 patients and covered the period from January 2012 to December 2019. During the follow-up, at least one revision surgery was performed on 559 patients (15.9%).
“This was a very well-constructed study in terms of sample size. Since the entire Finnish population was included, the patient cohort was large, allowing us to confirm previous findings,” Aakko said.
Patient data was obtained from the Care Register for Health Care (including both specialized and primary healthcare). The Finnish personal identity code enabled the integration of data from other sources, such as the Social Insurance Institution of Finland (for prescriptions, reimbursement numbers, and medication purchases) and Statistics Finland (for causes of death and mortality data). The study was sponsored by pharmaceutical company AstraZeneca.
Predictors of revision endoscopic sinus surgery in Finnish patients with chronic rhinosinusitis with nasal polyps. Toppila-Salmi S, Lyly A, Simin J, Aakko J, Haugom Olsen H, Lehtimäki L. Clinical and Translational Allergy (2025).
Find more RWE study summaries here.
Medaffcon, founded in 2009, is a Nordic research and consulting company specializing in Real-World Evidence, Medical Affairs, and Market Access. With offices in Stockholm, Sweden, and Espoo, Finland, we provide expert services across the Nordic region. Our services combine strong medical and health economic expertise with modern data science.
The company employs some 30 experts. Since 2017, Medaffcon has been a subsidiary of Tamro Oyj and is part of the PHOENIX group, which is a leading provider of healthcare services in Europe.
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Sr. Data Scientist
D.Sc. (Tech.)
Juhani joined Medaffcon in October 2020 as a data scientist. Prior to joining Medaffcon, Juhani has worked as a data scientist in a global IT company as well as a scientist at the University of Turku in the Medical Bioinformatics Centre (MBC) and Functional Foods Forum (FFF). Juhani holds a Doctor of Science in Technology degree (2017) and the topic of his thesis was the development of human gut microbiota in early infancy.
Juhani has experience from applying statistical and machine learning methods in medicine and due to his multidisciplinary background, he can easily communicate with people with varied expertise ranging from clinicians to IT-professionals. “Knowledge management and business intelligence have become hot topics also in the social and healthcare sectors. It is very interesting to be involved in harnessing the vast amounts of data available in the systems to actual usable information to support decision making. Both traditional statistics as well as advanced analytics and artificial intelligence will be in a key role in this job.”
Sr. Scientific Advisor
RWE Lead
PhD
+358 50 345 2393
mariann.lassenius@medaffcon.com
Mariann joined Medaffcon’s team in 2016 after finishing her PhD. The transition to real world evidence (RWE) research was a natural continuum to her previous research career. Through RWE studies, she has had the privilege to gain a broad insight into working with different stakeholders within the healthcare field. The vast proportion of her days goes towards interacting with clients, planning and performing RWE studies, and supporting Medaffcon’s RWE team. Subjects that keep her work interesting are the vast variability of customers and projects, problem-solving, and interacting with people.
“The number of RWE studies has increased since stakeholders within the healthcare industry have an increasing demand for knowledge-based decision making tools that need to be fulfilled. The future, therefore, has an ever-increasing emphasis on RWE”.