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European Archives of Oto-Rhino-Laryngology

Erschienen in:

18.08.2023 | Rhinology

Effectiveness and rapidity on olfatory fuction recovery in CRS patients treated with Dupilumab: a real life prospective controlled study

verfasst von: Ignazio La Mantia, Egle Grigaliute, Martina Ragusa, Salvatore Cocuzza, Thomas Radulesco, Alberto Maria Saibene, Christian Calvo-Henriquez, Nicolas Fakhry, Justin Michel, Antonino Maniaci

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 1/2024

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Abstract

Background

Recovery of olfactory function plays a prominent role in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). While rates and timing of such recovery vary, monoclonal antibodies might yield better results which we aimed at evaluating with this study.

Methodology

A prospective controlled study was conducted at our tertiary otolaryngological center from April 1, 2021, to October 1, 2022, in CRSwNP patients. We included an active group (n = 60 patients) performing dupilumab treatment and a control group (n = 60 patients) treated with intranasal and oral corticosteroids. Primary endpoints were changes in smell visual analogical scale (VAS) and SS-I (Sniffin' Sticks-identification) scores, and olfactory recovery rate. The secondary efficacy endpoints were nasal obstruction, rhinorrhea, headache, SNOT-22, and nasal congestion score (NCS).

Results

At 6 months, the active group demonstrated better outcomes than control in SS-I scores (10.23 ± 4.21 vs.3.68 ± 3.08; p < 0.001). No significant differences were found in blood eosinophil count, SNOT-22, and NPS (p > 0.05 for all). Olfactory function in the treatment arm improved in 86.66% (52/60 cases), with normal scores in 48.33% (29/60), while the control group reported a lower recovery rate (3/60; 5%), with no normal olfaction cases. Log-rank comparison for Kaplan–Meier functions was statistically significant (p < 0.001), but no differences were found in subanalysis in the active group based on blood eosinophil count at baseline, SNOT-22, and NPS scores.

Conclusions

Patients who receive dupilumab treatment may experience a faster recovery of olfactory function compared to those receiving corticosteroid therapy. This result would be maintained regardless of the severity of type 2 CRSwNP inflammation, the volume of the polyps, or the patient's subjective symptomatology.

Fokkens WJ, Lund VJ, Hopkins C et al (2020) European position paper on rhinosinusitis and nasal polyps. Rhinology 58(29):1–464. https://doi.org/10.4193/Rhin20.600CrossRefPubMed

Epperson MV, McCann AC, Phillips KM, Caradonna DS, Gray ST, Sedaghat AR (2021) Unbiased measure of general quality of life in chronic rhinosinusitis reveals disease modifiers. Laryngoscope 131(6):1206–1211. https://doi.org/10.1002/lary.29139CrossRefPubMed

Banoub RG, Hoehle LP, Phillips KM et al (2018) Depressed mood modulates impact of chronic rhinosinusitis symptoms on quality of life. J Allergy Clin Immunol Pract 6(6):2098–2105. https://doi.org/10.1016/j.jaip.2018.04.034CrossRefPubMed

Smith TL, Schlosser RJ, Soler ZM et al (2021) Olfactory cleft mucus inflammatory proteins in CRS: a case-control study. Int Forum Allergy Rhinol 11(9):1321–1335. https://doi.org/10.1002/alr.22770CrossRefPubMedPubMedCentral

Soler ZM, Yoo F, Schlosser RJ et al (2020) Correlation of mucus inflammatory proteins and olfaction in chronic rhinosinusitis. Int Forum Allergy Rhinol 10(3):343–355. https://doi.org/10.1002/alr.22499CrossRefPubMed

Migneault-Bouchard C, Hsieh JW, Hugentobler M, Frasnelli J, Landis BN (2020) Chemosensory decrease in different forms of olfactory dysfunction. J Neurol 267(1):138–143. https://doi.org/10.1007/s00415-019-09564-xCrossRefPubMed

Ahmed OG, Rowan NR (2020) Olfactory dysfunction and chronic rhinosinusitis. Immunol Allergy Clin North Am 40(2):223–232. https://doi.org/10.1016/j.iac.2019.12.013CrossRefPubMed

Thomas AJ, Mace JC, Ramakrishnan VR et al (2020) Quality-of-life and olfaction changes observed with short-term medical management of chronic rhinosinusitis. Int Forum Allergy Rhinol 10(5):656–664. https://doi.org/10.1002/alr.22532CrossRefPubMedPubMedCentral

Mattos JL, Soler ZM, Schlosser RJ et al (2021) Olfactory function after surgical treatment of CRS: a comparison of CRS patients to healthy controls. Am J Rhinol Allergy 35(3):391–398. https://doi.org/10.1177/1945892420960671CrossRefPubMed

10.

De Corso E, Pipolo C, Cantone E et al (2022) Survey on use of local and systemic corticosteroids in the management of chronic rhinosinusitis with nasal polyps: identification of unmet clinical needs. J Pers Med 12(6):897. https://doi.org/10.3390/jpm120608972CrossRefPubMedPubMedCentral

11.

Mullol J, Bachert C, Amin N et al (2022) Olfactory outcomes with dupilumab in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol Pract 10(4):1086-1095.e5. https://doi.org/10.1016/j.jaip.2021.09.037CrossRefPubMed

12.

Lee SE, Hopkins C, Mullol J et al (2022) dupilumab improves health related quality of life: results from the phase 3 SINUS studies. Allergy 77(7):2211–2221. https://doi.org/10.1111/all.15222CrossRefPubMed

13.

Bachert C, Han JK, Desrosiers M et al (2019) Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet 394(10209):1638–1650. https://doi.org/10.1016/S0140-6736(19)31881-1CrossRefPubMed

14.

Boscke R, Heidemann M, Bruchhage KL (2023) Dupilumab for chronic rhinosinusitis with nasal polyps: real-life retrospective 12-month effectiveness data. Rhinology 61(3):203–213. https://doi.org/10.4193/Rhin22.469CrossRefPubMed

15.

De Corso E, Settimi S, Montuori C et al (2022) Effectiveness of dupilumab in the treatment of patients with severe uncontrolled CRSwNP: a “real-life” observational study in the first year of treatment. J Clin Med 11(10):2684. https://doi.org/10.3390/jcm11102684CrossRefPubMedPubMedCentral

16.

van der Lans RJL, Fokkens WJ, Adriaensen GFJPM, Hoven DR, Drubbel JJ, Reitsma S (2022) Real-life observational cohort verifies high efficacy of dupilumab for chronic rhinosinusitis with nasal polyps. Allergy 77(2):670–674. https://doi.org/10.1111/all.15134CrossRefPubMed

17.

Haxel BR, Hummel T, Fruth K et al (2022) Real-world-effectiveness of biological treatment for severe chronic rhinosinusitis with nasal polyps. Rhinology 60(6):435–443. https://doi.org/10.4193/Rhin22.129CrossRefPubMed

18.

von Elm E, Altman DG, Egger M et al (2014) The strengthening the reporting of observational studies in epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 12(12):1495–1499. https://doi.org/10.1016/j.ijsu.2014.07.013CrossRef

19.

Reddel HK, Bacharier LB, Bateman ED et al (2021) Global initiative for asthma strategy 2021: executive summary and rationale for key changes. Eur Respir J 59(1):2102730. https://doi.org/10.1183/13993003.02730-2021CrossRefPubMed

20.

Meltzer EO, Hamilos DL, Hadley JA et al (2006) Rhinosinusitis: developing guidance for clinical trials. J Allergy Clin Immunol 118(5 Suppl):S17–S61. https://doi.org/10.1016/j.jaci.2006.09.005CrossRefPubMed

21.

Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) “Sniffin” sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22(1):39–52. https://doi.org/10.1093/chemse/22.1.39CrossRefPubMed

22.

Gudziol V, Lötsch J, Hähner A, Zahnert T, Hummel T (2006) Clinical significance of results from olfactory testing. Laryngoscope 116(10):1858–1863. https://doi.org/10.1097/01.mlg.0000234915.51189.cbCrossRefPubMed

23.

Oleszkiewicz A, Schriever VA, Croy I, Hähner A, Hummel T (2019) Updated Sniffin’ Sticks normative data based on an extended sample of 9139 subjects. Eur Arch Otorhinolaryngol 276(3):719–728. https://doi.org/10.1007/s00405-018-5248-1CrossRefPubMed

24.

Kennedy JL, Hubbard MA, Huyett P, Patrie JT, Borish L, Payne SC (2013) Sino-nasal outcome test (SNOT-22): a predictor of postsurgical improvement in patients with chronic sinusitis. Ann Allergy Asthma Immunol 111(4):246-251.e2. https://doi.org/10.1016/j.anai.2013.06.033CrossRefPubMedPubMedCentral

25.

Mattos JL, Rudmik L, Schlosser RJ et al (2019) Symptom importance, patient expectations, and satisfaction in chronic rhinosinusitis. Int Forum Allergy Rhinol 9(6):593–600CrossRefPubMedPubMedCentral

26.

Lin YT, Yeh TH (2022) Studies on clinical features, mechanisms, and management of olfactory dysfunction secondary to chronic rhinosinusitis. Front Allergy 3:835151CrossRefPubMedPubMedCentral

27.

Oka H, Tsuzuki K, Takebayashi H, Kojima Y, Daimon T, Sakagami M (2013) Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis. Auris Nasus Larynx 40(5):452–457. https://doi.org/10.1016/j.anl.2012.12.001CrossRefPubMed

28.

Kobal G, Hummel T, Sekinger B, Barz S, Roscher S, Wolf S (1996) “Sniffin’ sticks”: screening of olfactory performance. Rhinology 34(4):222–226PubMed

29.

Kohli P, Naik AN, Farhood Z et al (2016) Olfactory outcomes after endoscopic sinus surgery for chronic rhinosinusitis: a meta-analysis. Otolaryngol Head Neck Surg 155(6):936–948. https://doi.org/10.1177/0194599816664879CrossRefPubMed

Titel: Effectiveness and rapidity on olfatory fuction recovery in CRS patients treated with Dupilumab: a real life prospective controlled study
verfasst von: Ignazio La Mantia
Egle Grigaliute
Martina Ragusa
Salvatore Cocuzza
Thomas Radulesco
Alberto Maria Saibene
Christian Calvo-Henriquez
Nicolas Fakhry
Justin Michel
Antonino Maniaci
Publikationsdatum: 18.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 1/2024
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08184-6

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Effectiveness and rapidity on olfatory fuction recovery in CRS patients treated with Dupilumab: a real life prospective controlled study