Asthma affects the lower respiratory tract (bronchi), whereas chronic rhinosinusitis with nasal polyposis (CRSwNP) involves the upper airways. Despite this anatomical distinction, the upper and lower airways form a continuous respiratory tract and share common pathophysiological mechanisms. Consequently, asthma and CRSwNP frequently coexist, and several therapeutic strategies are effective for both conditions.
Given these overlaps, we hypothesize that a multidisciplinary consultation involving both a pulmonologist and an ENT specialist could be more effective than separate consultations for patient care. We also believe that this innovative organization that would benefit the healthcare system.
To test this hypothesis, we are conducting a study whose primary objective is to assess whether joint consultations lead to a reduction in oral corticosteroid need over the year following the initial consultation, by enabling more personalized treatment strategies.
Secondary outcomes will include the frequency of asthma exacerbations, frequency of ENT-related events, respiratory symptoms, quality of life, and healthcare ressources utilization.
We will compare outcomes between two patient groups: one receiving joint consultation from both specialists, and the other managed through standard, separate consultations as per current clinical practice.
Male or female, 18 years of age or older;
With a diagnosis of asthma;
With a diagnosis of chronic rhinosinusitis with nasal polyposis;
Whose asthma and/or chronic rhinosinusitis is/are not controlled according to SNOT-22 and ACQ-6 scores;
Patient in a period of exclusion from another research protocol at the time of consent signature;
Subjects covered by articles L1121-5 to 1121-8 of the French Public Health Code (adult patients under guardianship or curatorship, patients deprived of their liberty, pregnant or breast-feeding women);
Patients who do not read and/or understand French
Parallel
Joint consultation
Other interventionJoint consultation with pneumologist and ENT at baseline.
Mucus sampling
Procedure/SurgeryMucus sampling at baseline and one year follow-up
Nasal brushing
Procedure/SurgeryNasal brushing at baseline and one year follow-up
Effectiveness of joint ENT and pulmonologist consultation on relative change in cumulative annual dose of oral corticosteroids from the year before Baseline to the year between Baseline and 12 months visit.
Self reported cumulative annual dose of oral corticosteroids.
Reduction of asthma exacerbations frequency. Relative change from the year before Baseline to the year between baseline and 12 months visit in number of asthma exacerbations.
self-reported number of asthma exacerbations
Reduction of ENT events frequency. Relative change from the year before baseline to the year between baseline and 12 month visit in number of ENT events.
Self reported number of ENT events
Improvement of asthma control. Relative change from baseline to 12 months visit in ACQ-6 score
Self-administered questionnaire
Improvement of chronic rhinosinusitis with nasal polyposis control . Relative change from baseline to 12 months visit in SNOT-22 score
Self-administered questionnaire
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