D2.452 - Real-World Trends in the Epidemiology and Burden of Chronic Rhinosinusitis with Nasal Polyps Over Time in Germany Reveal Increasing Prevalence and Low Biologic Use

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition with frequent disease recurrence. Recent studies suggest that CRSwNP prevalence is rising and varies across regions, leading to increasing overall disease burden. This study describes trends in population and clinical characteristics, standard of care including treatment patterns, rates of surgery and recurrent surgery, and healthcare resource use among patients with CRSwNP in Germany.

This retrospective cohort study used health claims obtained from the WIG2 benchmark claims database in Germany from 1 January 2016 to 31 December 2023. Each calendar year from 2017 to 2023, a separate cohort was constructed, comprising patients with a diagnosis of CRSwNP in the year preceding 1 January of that year, resulting in 8 distinct annual cohorts. Adults (aged ≥18 years) were eligible if they had ≥2 outpatient diagnosis codes for nasal polyps or ≥1 inpatient diagnosis code for nasal polyps with continuous enrolment for ≥12 months.

Across the study period, statutory health insurance (SHI)‑projected CRSwNP prevalence varied slightly from year to year but the overall pattern reflected a gradual increase from 2017 to 2023 (395.1–531.8 per 100,000 SHI‑insured individuals). The prevalence of patients with inadequately controlled CRSwNP displayed moderate fluctuations (107.6–134.2 per 100,000). Cohort sizes consisted of 11,922 (2017) to 14,953 (2020) patients. Intranasal corticosteroids were consistently the most prescribed medication across different years (30.7–34.6%). Antibiotic usage was slightly higher (13.7–18.8%) compared with systemic corticosteroids during the study (9.3–11.1%). Biologic use was low across all years (0.40–3.69%) but increased over time. CRSwNP-related surgeries gradually declined from 5.4% in 2017 to 4.0% in 2023 and most patients had surgery in the first 2 years after index diagnosis; 19.1% of patients required more than one surgery during longitudinal follow-up. Healthcare resource use data showed hospitalisations slightly decreased across 2017–2023 while patient visits were stable (Table).

Results show a slow increase in prevalence of CRSwNP in Germany and heavy reliance on corticosteroids. Declining surgery rates across 2017–2023 coincided with an increased uptake of biologics; despite this, a fifth of patients required revision surgery, indicating scope for optimising long-term disease management.

Funding: GSK (224183)