Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
Int Arch Allergy Immunol. 2022;183(3):289-297. doi: 10.1159/000519296. Epub 2021 Oct 15.
Psychological disorders, such as depression, are markedly prevalent in patients with airway diseases. In this study, we assessed the effect of treatment with dupilumab, an IL-4 receptor α chain antibody, on depressive symptoms in a cohort of patients with asthma with eosinophilic chronic rhinosinusitis (ECRS).
The study participants, diagnosed with asthma and ECRS, were assessed for symptoms and quality of life (QOL) scores for asthma and ECRS and medications. The Patient Health Questionnaire-9 (PHQ-9) scores were used to evaluate the depressive state. The depressive symptoms were compared with asthma and ECRS symptoms both at the time of initiation and after 4 months of dupilumab treatment.
Ultimately, 31 patients were included in the study. Most patients demonstrated a depressive state that was correlated with the nasal symptom score. In the evaluation 4 months after dupilumab treatment, the PHQ-9 score was significantly reduced, and the decrease was remarkable in patients whose nasal symptom score was reduced by 50% or more. Additionally, the PHQ-9 scores in patients with improved nasal and asthma symptoms were significantly reduced.
DISCUSSION/CONCLUSION: Dupilumab may improve QOL in patients with bronchial asthma with ECRS by reducing depressive symptoms through the improvement of clinical symptoms.
心理障碍,如抑郁症,在气道疾病患者中明显高发。在这项研究中,我们评估了白细胞介素-4 受体 α 链抗体(dupilumab)治疗对伴嗜酸性慢性鼻-鼻窦炎(ECRS)哮喘患者抑郁症状的影响。
研究参与者被诊断为哮喘和 ECRS,评估哮喘和 ECRS 的症状和生活质量(QOL)评分以及药物使用情况。使用患者健康问卷-9(PHQ-9)评分评估抑郁状态。比较了开始时和 dupilumab 治疗 4 个月后的抑郁症状与哮喘和 ECRS 症状。
最终,31 名患者纳入研究。大多数患者表现出与鼻部症状评分相关的抑郁状态。在 dupilumab 治疗 4 个月后的评估中,PHQ-9 评分显著降低,且鼻部症状评分降低 50%或更多的患者降低幅度显著。此外,鼻部和哮喘症状改善的患者 PHQ-9 评分显著降低。
讨论/结论:通过改善临床症状,dupilumab 可能通过减轻抑郁症状来提高伴 ECRS 支气管哮喘患者的生活质量。