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Original Article


Clinical Management and Use of Health Care Resources in the Treatment of Nasal Polyposis in Spanish Allergy Centers: The POLAR Study


Rondón C1, Dávila I2, Navarro Pulido AM3, Sánchez MC4, Montoro J5, Matheu V6, Lluch-Bernal M7, Fernández-Parra B8, Ibáñez MD9, Dordal MT10, Colás C11, Antón E12, Valero A13; Rhinoconjunctivitis Committee; Spanish Society of Allergy and Clinical Immunology

1Allergy Unit, Regional University Hospital of Malaga, IBIMA, UMA, Malaga, Spain
2Allergy Service, University Hospital of Salamanca, Instituto de Investigaciones Biosanitarias de Salamanca, IBSAL, Salamanca, Spain
3Allergy UGC-IC, Hospital El Tomillar, Dos Hermanas, Sevilla, Spain
4Allergy Unit, CE Virgen de la Cinta, Hospital Juan Ramón Jimenez, Huelva, Spain
5Allergy Unit, Hospital Universitario Arnau de Vilanova, Facultad de Medicina, Universidad Católica de Valencia “San Vicente Mártir”, Valencia, Spain
6Allergy Service, Hospital del Tórax (Ofra), Complejo Hospitalario Universitario NSC and Unidad de Investigación, Hospital Universitario NS Candelaria, Tenerife, Spain
7Allergy Service, Hospital Virgen del Valle, Toledo, Spain
8Allergy Service, Hospital El Bierzo, Ponferrada, León, Spain
9Allergy Service, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
10Allergy Service, Hospital Municipal de Badalona, Badalona, Spain and Allergy Service, Sant Pere Claver Fundació Sanitària, Barcelona, Spain
11Allergy Service, Hospital Clínico-Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
12Allergy Service, University Hospital Marqués de Valdecilla, Santander, Spain
13Allergy Unit, Servei de Pneumologia i Al·lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Centro de Investigación Biomédica en red en Enfermedades Respiratorias (CIBERES), Spain

J Investig Allergol Clin Immunol 2015; Vol. 25(4): 276-282



Background: Nasal polyposis (NP) is a chronic inflammatory disease that constitutes a major health problem with significant comorbidities and a considerable associated socioeconomic burden.

Objective: To describe the clinical features and management of patients with NP attending Spanish allergy centers, the use of health care resources, and the degree of compliance with the diagnostic and therapeutic recommendations of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS).

Methods: We performed a multicenter, observational, and cross-sectional epidemiologic study of 671 patients consulting for NP in 67 Spanish allergy departments. We used sociodemographic and clinical questionnaires to evaluate clinical characteristics, use of health care resources, diagnostic methods, and treatment administered.

Results: NP was closely associated with asthma (66%), allergic rhinitis (45.9%), and hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (26%). Atopy was present in the 50% of cases, with Dermatophagoides pteronyssinus as the most frequent sensitizing allergen. Eleven percent of NP patients visited the emergency department during the previous year, and more than 58% used primary care, allergy, or otorhinolaryngology services. The most frequently used diagnostic tests were skin prick tests (93.6%) and anterior rhinoscopy (79.4%). Intranasal corticosteroids were the drug class most frequently prescribed by allergists (74.6%). Specific immunotherapy was prescribed in 21% of patients.

Conclusions: NP is a chronic inflammatory disease that generates considerable use of health care resources. The close association with atopy, asthma, and NSAID hypersensitivity highlights the usefulness of an allergy workup in all patients with NP. Analysis of the clinical management of NP by allergists in Spain revealed a high degree of compliance with EPOS diagnostic and therapeutic recommendations.

Key words: Allergological evaluation. Atopy. Health care resources. Nasal polyps. Diagnosis. Treatment.