Incidence of Chronic Rhinosinusitis and Sinus Surgery in Patients Who Receive Rituximab

Sunday, October 12, 2025

1:42 PM - 1:48 PM EDT

Location: 125

Disclosure(s):

Bastien A. Valencia, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kendra N. Walker, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Prishae M. Wilson, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Angela M. Donaldson, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Rituximab use causes B-cell depletion and hypogammaglobulinemia, increasing the risk for infectious complications. While immunosuppressive therapy has been linked to chronic rhinosinusitis (CRS), the relationship between rituximab use and CRS development remains poorly explored. This study defines the incidence of CRS and endoscopic sinus surgery (ESS) following rituximab use.

Methods: Data were retrospectively collected from all Mayo Clinic sites using the Mayo Data Explorer. Patients with a history of rituximab prescription were included, and those diagnosed with CRS before rituximab initiation were excluded. Demographics, surgical data, and CRS diagnoses (from January 1, 2019 onward) were collected.

Results: Among 17,851 patients prescribed rituximab (mean age 61.1 years, M:F ratio 1.1:1), 1,105 (6.2%) developed CRS following rituximab use, with an annual incidence of 1.03% (1,032 cases per 100,000 person-years). Most CRS cases occurred after rituximab discontinuation (62.7%, n=693) compared to during active treatment (37.3%, n=412). Of the patients with CRS, 149 (13.5%) underwent ESS, with more procedures performed after rituximab completion (n=94) than during active use (n=45).

Conclusions: This study demonstrates an annual incidence of 1.03% for CRS diagnoses following rituximab use. While prior studies report varying CRS incidences in the general population (0.25%-1.1%), our findings suggest an increased risk among rituximab users. Most CRS cases and ESS procedures occurred after rituximab discontinuation, emphasizing the need for a comprehensive review of medication history during CRS clinical evaluation.

Co-Author(s)

Bastien A. Valencia, MD

Postdoctoral Research Fellow
Mayo Clinic
Jacksonville, Florida, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Presenting Author(s)

Kendra N. Walker, MD

Resident
Mayo Clinic in Florida
Neptune Beach, FL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Prishae M. Wilson, BS

Research Fellow
Mayo Clinic
Columbia, South Carolina, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
NN

Natasha Najmi, BS

Mayo Clinic in Florida, United States

Disclosure information not submitted.

Senior Author(s)

AD

Angela M. Donaldson, MD

Associate Professor
Mayo Clinic
Jacksonville, FL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.