Deconstructing Barriers in Support of the Systemic Management of Chronic Rhinosinusitis With Nasal Polyps

Deconstructing Barriers in Support of the Systemic Management of Chronic Rhinosinusitis With Nasal Polyps

Online Course | Specialties: Otolaryngology
Released: 12/16/2021
Expires: 12/15/2022
Max Credits: 0.5
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William Busse, MD
Emeritus Professor of Medicine
Division of Allergy, Pulmonary, and Critical Care Medicine
University of Wisconsin School of Medicine and Public Health
Madison, WI

Christine Franzese, MD
Professor of Clinical Otolaryngology
Director of Allergy
University of Missouri School of Medicine
Columbia, MO

Activity Planners
Sara Samuel, MSc, MPhil, MS
Clinical Content Manager
Baltimore, MD

Rebecca L. Julian, MS, ELS
Senior Manager, Editorial
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Haifa Kassis, MD
West Roxbury, MA

Learning Objectives
Upon completion, participants should be able to:

  • Discuss the disease burden of CRSwNP and its potential effects on patient quality of life
  • Identify the common underlying pathophysiologic mechanisms involved in CRSwNP and the spectrum of inflammatory diseases
  • Adopt an individualized, interdisciplinary treatment approach for CRSwNP that incorporates current treatment modalities and optimizes outcomes

Target Audience
This activity is intended for otolaryngologists.
Statement of Need
Patients who have chronic rhinosinusitis with nasal polyps (CRSwNP) experience recurring nasal polyps that can greatly reduce their quality of life; however, many clinicians dismiss CRSwNP as simply a “chronic runny nose.” The current standard of care consists of symptomatic relief and surgery if less-invasive steroid treatments are insufficient. However, polyp recurrence after surgery is common; in fact, rates are as high as 50% over the course of 3 years. Recent research has revealed an underlying immunologic cause for CRSwNP, which has informed the development of new and emerging biologic therapies that target type 2 inflammation. Thus, healthcare providers can benefit from education on current evidence regarding CRSwNP and management approaches, as well as best practices for facilitating care coordination.

Providership Statement
Provided by Med-IQ.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Med-IQ designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

Medium/Method of Participation
This is a 0.5-credit CE activity. To receive credit, read the introductory CE material, complete all of the modules, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: December 16, 2021
Expiration Date: December 15, 2022
Estimated Time to Complete This Activity: 30 minutes

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Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity. 

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

William Busse, MD
Consulting fees/advisory boards: AstraZeneca, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Regeneron Pharmaceuticals, Inc., Sanofi-aventis U.S. Inc.
Fees received for promotional/non-CE activities: Regeneron Pharmaceuticals, Inc., Sanofi-aventis U.S. Inc.

Christine Franzese, MD
Consulting fees/advisory boards: Genentech, GlaxoSmithKline, Optinose, Regeneron Pharmaceuticals, Inc.
Fees received for promotional/non-CE activities: AstraZeneca, Genentech, GlaxoSmithKline, Optinose, Regeneron Pharmaceuticals, Inc., Sanofi-aventis U.S. Inc.
Contracted research: AstraZeneca, Bellus Health, GlaxoSmithKline, Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Optinose, Regeneron Pharmaceuticals, Inc., Sanofi-aventis U.S. Inc., Shionogi

The writer, peer reviewers, and other activity planners have no financial relationships to disclose.
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

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Complimentary CE
This activity is available free of charge to participants.

Acknowledgment of Commercial Support
This activity is supported by an educational grant from Regeneron Pharmaceuticals, Inc. and Sanofi Genzyme.


Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • Chronic rhinosinusitis with nasal polyps (CRSwNP) is a condition of sinonasal inflammation with the presence of nasal polyps
  • Polyps typically develop bilaterally in the nasal cavity
  • Symptoms include nasal obstruction or blockage, rhinorrhea or postnasal drip, impaired smell, and facial pain or pressure
  • CRSwNP is associated with impaired HRQOL
  • Common risk factors for developing CRSwNP include asthma, gene polymorphisms, and aging
  • The current standard of care includes medical and surgical approaches; however, these approaches may be associated with CRSwNP recurrence and increased risk of adverse events
  • Underlying type 2 inflammation can cause allergic disease with elevated expression of cytokines IL-4, IL-5, and IL-13, as well as hyperproduction of IgE and eosinophilic inflammation
  • Targeted biologic medications have been shown to have benefits in the management of CRSwNP, including improved HRQOL, nasal polyp size, and nasal congestion symptoms

View reference list.

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