Thoracic Medicine, University College London Hospital NHS Foundation Trust, London, United Kingdom.
Rhinology Section, Royal National Throat Nose and Ear Hospital London, London, United Kingdom.
Rhinology. 2018 Mar 1;56(1):42-45. doi: 10.4193/Rhino17.139.
Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy.
To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP.
SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma. SNOT-22 in a surgery only treated CRSwNP with asthma group (n=24) was compared.
Rapid improvement was seen at 4 weeks and 16 weeks of treatment in both CRSwNP and asthma control. The improvement in CRSwNP with Omalizumab was similar to that seen in a group of patients who received upper airway surgery.
Omalizumab treatment for severe allergic asthma also improves co-existent CRSwNP. Further clinical studies of current and emerging biological agents for severe asthma should include upper airway outcomes. These agents may be effective for severe CRSwNP and comparative studies with surgery are warranted.
伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）和哮喘常同时存在，因此，用一种干预手段同时治疗这两种疾病是一种很有吸引力的策略。
前瞻性评估针对 IgE 的单克隆抗体奥马珠单抗治疗严重变应性哮喘是否也能有效治疗并存的 CRSwNP。
根据英国严重哮喘指南，对患有 CRSwNP 和严重难治性变应性哮喘的患者队列（n=13），按照奥马珠单抗治疗严重哮喘的英国指南，分别在治疗的第 4 周和第 16 周记录 SNOT-22 和 ACQ-7 评分。比较仅行手术治疗 CRSwNP 合并哮喘的患者组（n=24）的 SNOT-22。
在治疗的第 4 周和第 16 周，CRSwNP 和哮喘控制均迅速改善。奥马珠单抗治疗 CRSwNP 的改善情况与接受上气道手术的患者组相似。
奥马珠单抗治疗严重变应性哮喘也可改善并存的 CRSwNP。目前和新出现的严重哮喘生物制剂的进一步临床研究应包括上气道结局。这些药物可能对严重 CRSwNP 有效，需要与手术进行比较研究。
