Africa and colleagues. Analyzing health records from the TriNetX database covering 106 healthcare organizations in the United States between Jan. 1, 2010, and July 31, 2025, researchers found that anti-rejection medications influence patient vulnerability to chronic sinus conditions and dangerous fungal infections.
Induction Therapies: Basiliximab Versus Anti-Thymocyte Globulin
When looking at induction therapy, researchers compared basiliximab directly against anti-thymocyte globulin (ATG). Basiliximab linked to higher rates of allergic rhinitis, chronic rhinosinusitis with nasal polyposis, and acute invasive fungal sinusitis. Documented relative risks for these conditions under basiliximab stood at 0.89 with a 95% confidence interval of 0.82–0.96 for allergic rhinitis, 0.62 for chronic rhinosinusitis with nasal polyposis, and 0.43 for acute invasive fungal sinusitis, as noted by the study.
Surgical intervention rates mirrored those disease distributions across the cohort. Functional endoscopic sinus surgery rates were higher among patients treated with basiliximab for chronic rhinosinusitis without nasal polyposis, chronic rhinosinusitis with nasal polyposis, and acute invasive fungal sinusitis. The reported relative risks for undergoing the procedure were 0.60, 0.70, and 0.62 respectively, highlighting a heavier downstream procedural burden for this specific patient group.
Maintenance Protocols: Tacrolimus and Cyclosporine Compared
Beyond initial induction, the study evaluated long-term maintenance immunosuppression by contrasting tacrolimus-based regimens with cyclosporine-based protocols. Maintenance treatment utilizing tacrolimus demonstrated higher rates of allergic rhinitis and acute invasive fungal sinusitis relative to cyclosporine. The reported relative risks reached 1.29 for allergic rhinitis and 1.73 for acute invasive fungal sinusitis.
Interestingly, surgical interventions for sinonasal diseases did not display the same disparity between the two maintenance drugs. Rates of surgery for chronic rhinosinusitis without nasal polyposis, chronic rhinosinusitis with nasal polyposis, and acute invasive fungal sinusitis remained similar between the tacrolimus and cyclosporine treatment cohorts. The respective relative risks documented for these surgical operations were 1.11, 0.89, and 1.13.
Frequently Asked Questions
What data source did the study utilize?
The study utilized the TriNetX database, covering data from 106 healthcare organizations in the United States between Jan. 1, 2010, and July 31, 2025.
Which induction medication was linked to higher rates of acute invasive fungal sinusitis?
Basiliximab was associated with higher rates of acute invasive fungal sinusitis compared to anti-thymocyte globulin.
Did maintenance drugs change the rate of sinus surgeries?
Surgical rates for sinonasal conditions remained similar between tacrolimus-based and cyclosporine-based maintenance treatment groups.
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