Association of autoimmune diseases with chronic rhinosinusitis in general practices in Germany

Several population-based studies have reported increased prevalence of autoimmune diseases (AID) in patients with chronic rhinosinusitis (CRS). Large-scale datasets from Taiwan demonstrated associations between CRS and conditions such as rheumatoid arthritis, ankylosing spondylitis, polymyositis, psoriasis, Sjögren’s syndrome, and systemic lupus erythematosus (SLE) (1,2). However, sex-specific patterns have not been investigated. We examined associations between CRS and 20 pre-existing AID using a nationally representative primary care database, with a focus on sex-specific differences. Data were drawn from the IQVIA Disease Analyzer (>1,300 general practices in Germany, including diagnoses and prescriptions). Adults with an initial diagnosis of CRS (ICD-10: J32) between 2010–2024 were matched 1:1 to controls without CRS or nasal polyps (J33), based on age, sex, observation time, and CRS-related comorbidities (3) (Figure S1, online supplement). Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals, stratified by sex. We also performed subgroup analyses by age, asthma, allergy, and nicotine dependence.