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. 2025 Jul 16:18:9401-9411.
doi: 10.2147/JIR.S533652. eCollection 2025.

Rheumatoid Arthritis Aggravates Disease Severity and the Risk of Postoperative Recurrence in Chronic Rhinosinusitis

Xiaoying Zhou #  1 , Dan Wang #  2 , Shouming Cao  1 , Yi Tu  1 , Rui Chen  1 , Haosu Huang  1 , Wenrong Lou  3
Affiliations

Rheumatoid Arthritis Aggravates Disease Severity and the Risk of Postoperative Recurrence in Chronic Rhinosinusitis

Xiaoying Zhou et al. J Inflamm Res. .

Abstract

Objective: Rheumatoid arthritis (RA) may share pathophysiological mechanisms with chronic rhinosinusitis (CRS), but its impact on CRS remains unclear. This study aimed to investigate the associations between RA and CRS disease severity, as well as postoperative recurrence risk.

Methods: A retrospective analysis was conducted on CRS patients who underwent functional endoscopic sinus surgery. Patients were divided into subgroups based on the presence of RA and gender. CRS patients were followed up for three years and categorized into non-recurrent and recurrent groups. Binary logistic regression analyses were performed to investigate the impact of RA on the risk of postoperative recurrence in CRS.

Results: Among 568 CRS patients, 169 experienced recurrence after three years. The RA group showed a significantly higher recurrence rate than the non-RA group in both genders (P < 0.05). In addition, RA patients had younger age, higher body mass index, higher prevalence of nasal polyps, and higher baseline VAS, Lund-Kennedy, and Lund-Mackay scores. At three-year follow-up, the RA group demonstrated greater improvements in VAS and Lund-Kennedy scores (P < 0.05). Logistic regression identified RA, allergic rhinitis, and asthma as independent risk factors for CRS recurrence (P < 0.05). Unadjusted and adjusted analysis highlighted RA as an independent predictor in males and females. Kaplan-Meier analysis further revealed that RA was associated with a significantly higher risk of postoperative CRS recurrence (P < 0.05).

Conclusion: RA might aggravate the disease severity and affect the prognosis of CRS. Additionally, RA may be a potential risk factor for postoperative recurrence of CRS, regardless of gender.

Keywords: chronic rhinosinusitis; functional endoscopic sinus surgery; recurrence; rheumatoid arthritis.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Comparison of baseline scores of different symptom scales between non-RA group and RA group in both male and female CRS patients. (A–C) VAS score; (D–F) Lund-Kennedy score; (G–I) Lund-Mackay score. Data are presented as median (IQR).
Figure 2
Figure 2
The improvements of VAS and Lund-Kennedy scores in male and female CRS patients after 3 years of follow-up. (A–C) VAS score; (D–F) Lund-Kennedy score. Data are presented as median (IQR). T0: baseline; T3: 3 years after surgery.
Figure 3
Figure 3
Kaplan-Meier curve analyzing the association between RA and the risk of postoperative recurrence of CRS. (A) all patients; (B) male; (C) female.
See this image and copyright information in PMC

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