{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:24:42Z","timestamp":1787761482235,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether treatment responses to the exhalation delivery system with fluticasone (EDS\u2010FLU; XHANCE\u00ae) differ between patients with CRS with nasal polyps (CRSwNP) and patients without nasal polyps (CRSsNP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Post hoc analysis of the ReOpen clinical trials conducted between November 2018 and November 2021 for a 24\u2010week duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Multinational, multicenter, randomized, EDS\u2010placebo\u2010controlled studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were pooled from the randomized trials in which patients with CRSwNP (n\u2009=\u2009206) or CRSsNP (n\u2009=\u2009341) were randomly assigned (1:1:1) to EDS\u2010FLU 186\u2009\u03bcg, 372\u2009\u03bcg, or EDS\u2010placebo, 1 or 2 sprays twice daily per nostril for 24 weeks. Endpoints included composite symptom score, Smell Identification Test (SIT), sinus opacification on computed tomography (CT) scan, frequency of acute exacerbations of CRS, 22\u2010Item Sino\u2010Nasal Outcome Test (SNOT\u201022), and Patient Global Impression of Change (PGIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with CRSwNP and CRSsNP reported substantially greater benefits with EDS\u2010FLU versus EDS\u2010placebo on symptoms, SIT, sinus opacification on CT scan, incidence of acute exacerbations of CRS, and quality\u2010of\u2010life outcomes (SNOT\u201022 and PGIC). Composite symptom score and SNOT\u201022 improvements were consistent in the subgroup of patients entering the trial reporting symptoms despite recent standard\u2010delivery nasal steroid spray use. Treatment\u2010by\u2010subgroup interaction effects indicated similar magnitude EDS\u2010FLU treatment effect for patients with CRSwNP and patients with CRSsNP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EDS\u2010FLU improved subjective and objective measures of CRS irrespective of nasal polyp status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Title: Study Evaluating the Efficacy and Safety of Intranasal Administration of OPN\u2010375 in Subjects With Chronic Rhinosinusitis With or Without the Presence of Nasal Polyps; ID: NCT03781804 and NCT03960580, Clinicaltrials.gov.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70406","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:50:48Z","timestamp":1787759448000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Exhalation Delivery System With Fluticasone in Chronic Rhinosinusitis With Versus Without Polyps"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6480-0275","authenticated-orcid":false,"given":"Rodney J.","family":"Schlosser","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh K.","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Mississippi Medical Center Jackson Mississippi USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5373-5559","authenticated-orcid":false,"given":"Greg E.","family":"Davis","sequence":"additional","affiliation":[{"name":"Ear Nose Throat and Allergy Associates, Proliance Surgeons Seattle and Puyallup Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4004-203X","authenticated-orcid":false,"given":"Mahboobeh","family":"Mahdavinia","sequence":"additional","affiliation":[{"name":"Division of Allergy &amp; Immunology UT Health Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Messina","sequence":"additional","affiliation":[{"name":"Clinical Research and Medical Affairs Optinose US, Inc Yardley Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-982X","authenticated-orcid":false,"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0745-2379","authenticated-orcid":false,"given":"Anju T.","family":"Peters","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Sindwani","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Department, Integrated Surgery Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"White","sequence":"additional","affiliation":[{"name":"Division of Allergy, Asthma and Immunology Scripps Clinic San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Wise","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22741"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.03.005"},{"issue":"29","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhin20.600","article-title":"European position paper on rhinosinusitis and nasal polyps 2020","volume":"58","author":"Fokkens WJ","year":"2020","journal-title":"Rhinol J"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2023.12.016"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13346-012-0108-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000199741.08517.99"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2011.0924"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.06.010"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892418810281"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23434"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318184e216"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.01.023"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.857"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.07.009"},{"key":"e_1_2_9_16_1","unstructured":"Xhance [package insert]. 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