New real-world study reveals oral corticosteroid overuse in patients with chronic rhinosinusitis with nasal polyps

• According to the ACTIONS study, 39% of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) faced overexposure to oral corticosteroids (OCS) before beginning biologic therapy.
• ACTIONS was carried out by GSK in collaboration with Asthma Canada and leading Canadian Rhinologists.

MISSISSAUGA, ON, June 10, 2025 /CNW/ - A new Canadian real-world study, ACTIONS (chAracterizing oral Corticosteroid use in patients with chronic rhInOsinusitis with Nasal polypS in Canada), revealed patterns of oral corticosteroid (OCS) use among patients with chronic rhinosinusitis with nasal polyps (CRSwNP) prior to starting biologic treatments. The full findings were recently presented at the Canadian Society of Otolaryngology Head and Neck Surgery Annual Meeting in Fredericton, New Brunswick.

The study findings revealed that 81% of CRSwNP patients were prescribed OCS at least once in the 24 months prior to starting a biologic treatment with 39% of patients being overexposed to OCS by the time they started a biologic. These findings highlight the need for heightened awareness and education to prevent OCS overexposure and enhance patient care.

CRSwNP is a chronic inflammatory disease of the paranasal sinuses and nasal mucosa leading to the growth of nasal polyps;¹ CRSwNP is associated with significant disease burden which negatively affects patients' quality of life.² Treatment for CRSwNP involves a combination of medical and surgical interventions. OCS are a common and effective medical treatment option for patients with CRSwNP, often used alongside nasal saline irrigation for short-term control of symptoms.³ Despite their proven short-term efficacy, OCS are also associated with increased risk of short- and long-term adverse effects, with guidelines in respiratory disease recommending limiting use when possible. ^4,5

Biologics have emerged as a newer treatment option with demonstrated effectiveness in managing CRSwNP, including decreasing the dependence on OCS.^6-8 The ACTIONS study revealed critical patterns of OCS use among CRSwNP patients, underscoring a significant unmet need that healthcare professionals should address.

ACTIONS was conducted by GSK and Asthma Canada in collaboration with Dr. Yvonne Chan from the University of Toronto, Dr. Marie-Noëlle Corriveau from Université Laval, and Dr. Andrew Thamboo from the University of British Columbia, with research support, input, and analytics provided by IQVIA Solutions Canada Inc.

"Our findings indicate that a significant proportion of severe CRSwNP patients are at risk of OCS overexposure. By considering earlier biologic initiation, when indicated, we can potentially reduce this risk and improve patient outcomes. Furthermore, collaboration among healthcare providers to promote awareness and adherence to these protocols will be vital in transforming patient care," said Dr. Marie-Noëlle Corriveau. 

"The data clearly indicate that a proactive strategy involving earlier biologic therapy can play a pivotal role in managing CRSwNP more efficiently. Embracing these new approaches is not just beneficial, but essential for improving the quality of life for our patients," said Dr. Yvonne Chan.

"CRSwNP and asthma often coexist, share underlying mechanisms and influence each other's severity and management. This study is a critical step forward in understanding the treatment landscape for CRSwNP. It shows how vital it is to reduce our dependence on OCS and to find more sustainable and effective treatments. Ultimately, this could mean better health and quality of life for patients," said Jeffrey Beach, President & CEO, Asthma Canada.

"As a leader in respiratory health, GSK remains committed to be at the forefront of the fight against respiratory disease. The ACTIONS study further underscores this dedication by providing valuable insights, fostering scientific and research excellence, and driving innovation," added Dr. Michelle Horn, Country Medical Director, GSK Canada.

About CRSwNP

CRSwNP is caused by inflammation of the nasal lining that can lead to soft tissue growths, known as nasal polyps.^3,6 People with CRSwNP experience symptoms such as nasal obstruction, loss of smell, facial pain, sleep disturbance, infections and nasal discharge that can significantly affect their emotional and physical well-being.^1,6,10-11 IL-5 is a key cytokine (protein) in type 2 inflammation characterized by eosinophils (a type of white blood cell), which is present in up to 85% of people with CRSwNP.^1,6,10,11 IL-5 and eosinophils are frequently found in high concentrations in sinus and nasal polyp tissue of patients with CRSwNP and are associated with more severe disease.^13-19

About OCS

Oral corticosteroids (OCS) are systemic anti-inflammatory medications used to manage inflammatory conditions, including respiratory diseases, and allergic reactions. Unlike inhaled corticosteroids (ICS), which target the lungs directly, and intranasal corticosteroids (INCS) which target the nasal airways, OCS are ingested and distributed throughout the body. Common types include prednisone, methylprednisolone, and hydrocortisone. The use of OCS, including in repeated short bursts, can lead to significant health risks. The wide range of adverse effects associated with OCS include increased risk of infection and cardiovascular events, osteoporosis, type 2 diabetes mellitus, weight gain, and mood and behaviour disturbances.²⁰ In the ACTIONS study, overexposure to OCS is defined as total yearly dose of OCS ≥1,000 mg given that the risk of adverse effects significantly increases once a patient receives a cumulative lifetime exposure of 1000mg of OCS.²⁰

About GSK in respiratory

GSK continues to build on decades of pioneering work to deliver more ambitious treatment goals, develop the next generation standard of care, and redefine the future of respiratory medicine for hundreds of millions of people with respiratory diseases. With an industry-leading respiratory portfolio and pipeline of vaccines, targeted biologics and inhaled medicines, we are focused on improving outcomes and the lives of people living with all types of asthma and COPD along with less understood refractory chronic cough or rarer conditions like systemic sclerosis with interstitial lung disease. GSK is harnessing the latest science and technology with the aim of modifying the underlying disease dysfunction and preventing progression.

About GSK

GSK is a global biopharma company with a purpose to unite science, technology, and talent to get ahead of disease together. Find out more at gsk.ca.

References

	1 Bachert C, et al. J Asthma Allergy. 2021;14:127–134
	2 Mullol J, et al. J Allergy Clin Immunol Pract. 2022;10:1434–1453.e1439
	3 Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. Available at: https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf
	4. Hox V, et al. Clin Transl Allergy. 2020;10:1-27.
	5  Fokkens, W. J., et al. (2020). "European Position Paper on Rhinosinusitis and Nasal Polyps 2020." Rhinology 58(Suppl S29): 1-464.
	6 Han, J. K., et al. (2021). Lancet Respir Med 9(10): 1141-1153.
	7 Bachert, C., et al. (2019). Lancet 394(10209): 1638-1650.
	8 Gevaert, P., et al. (2020). J Allergy Clin Immunol 146(3): 595-605.
	9 Bachert, C., et al. (2021). J Allergy Clin Immunol 147(1): 29-36.
	10Kato A, et al. Endotypes of chronic rhinosinusitis: Relationships to disease phenotypes, pathogenesis, clinical findings, and treatment approaches. Allergy. 2022;77(3):812-826.
	11De Corso E, et al. How to manage recurrences after surgery in CRSwNP patients in the biologic era: a narrative review. Acta Otorhinolaryngol Ital. 2023;43(Suppl.1):S3-S13.
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SOURCE GlaxoSmithKline Inc.

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