title: Management of chronic rhinosinusitis with nasal polyps and coexisting asthma: A systematic review.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and asthma are strongly associated, and patients suffering from both diseases are often difficult to treat. However, no guidelines about the management of patients with CRS and coexisting asthma exist.
  
  
  OBJECTIVE
  The purpose of this systematic review was to evaluate the management of CRSwNP and coexisting asthma.
  
  
  METHODS
  We systematically searched electronic databases and included clinical trials in which the clinical outcomes after medical or surgical treatment of patients with CRSwNP and asthma were assessed. The strength of the evidence for each outcome was graded on the basis of study quality and consistency in findings.
  
  
  RESULTS
  We included seven trials in which the effect of montelukast, omalizumab, erythromycin, and functional endoscopic sinus surgery (FESS) were studied in 317 adults with CRSwNP and asthma. All the interventions improved the majority of subjective and objective nasal outcomes significantly. However, few studies found significant effects on pulmonary function tests. The strength of the evidence was low overall.
  
  
  CONCLUSIONS
  Both FESS and medical interventions with systemic anti-inflammatory drugs improved nasal outcomes, although their efficacy in relation to the lower airways remains unclear. A low number of studies met inclusion criteria for this systematic review, which emphasizes the need for high-quality trials to explore the treatment of patients with CRSwNP and coexisting asthma.
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Iben
authors.initials: I
authors.lastname: Rix
authors.forename: Kåre
authors.initials: K
authors.lastname: Håkansson
authors.forename: Christian Grønhøj
authors.initials: CG
authors.lastname: Larsen
authors.forename: Martin
authors.initials: M
authors.lastname: Frendø
authors.forename: Christian
authors.initials: C
authors.lastname: von Buchwald
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology* / Q000628:therapy*; D002908:Chronic Disease; D003521:Cyclopropanes; D004724:Endoscopy; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D009298:Nasal Polyps / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy*; D000069444:Omalizumab / Q000627:therapeutic use; D011788:Quality of Life; D011804:Quinolines / Q000627:therapeutic use; D012220:Rhinitis / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy*; D012852:Sinusitis / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy*; D013440:Sulfides
chemical_list: D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D000069444:Omalizumab; C093875:montelukast