Tat Tuğba Songül
Allergy and Immunology Unit, Gaziantep Medical Park Hospital, Gaziantep, Turkey.
Hasan Kalyoncu University, Gaziantep, Turkey.
World Allergy Organ J. 2022 Aug 10;15(8):100670. doi: 10.1016/j.waojou.2022.100670. eCollection 2022 Aug.
Chronic rhinosinusitis with nasal polyposis (CRSwNP) can be recalcitrant in some patients despite medical therapies and surgery and has higher morbidity. Omalizumab is a new treatment option for patients with CRSwNP. The aim of this study is to evaluate the efficacy and safety of omalizumab (anti-IgE antibody) in patients with CRSwNP.
The efficiency and adverse effects of omalizumab were evaluated based on the data extracted from medical records of patients with CRSwNP. Patients were evaluated monthly for efficacy and adverse reactions. Treatment efficacy was evaluated by visual analog scale (VAS) for rhinorrhea, postnasal drip, sneeze, smell, and nasal stuffiness complaints, sinonasal outcome test-22 (SNOT-22), and nose obstruction symptom evaluation (NOSE) score.
17 patients with CRSwNP formed our cohort. The mean (SD) age, weight, and total IgE level were 41.9 (9.4) years, 78.6 (15) kg, and 198.8 (169.2) IU/mL, respectively. 3 patients had mild, 6 had moderate and 1 had severe asthma as comorbidity. The mean (SD) duration of omalizumab treatment and polypectomy numbers were 9.2 (13.3) months and 2.9 (1.5), respectively. All patients had at least one polyp surgery. All sinonasal outcome parameters were significantly improved by the omalizumab treatment, also in subgroups with and without asthma. The median changes from baseline at the last visit date for omalizumab treatment were as follows: SNOT-22 score decreased from 98 to 19, NOSE score decreased from 100 to 20, the VAS for postnasal drip, rhinorrhea, nasal stuffiness, smell and sneeze decreased from 8 to 2, 8 to 2, 10 to 3, 10 to 2, 6 to 1, respectively (P < 0.001). Patients experienced no adverse reaction with omalizumab treatment.
Omalizumab was an effective treatment in patients with recalcitrant CRSwNP with or without asthma.
尽管采用了药物治疗和手术，但慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）在一些患者中仍难以治愈，且发病率较高。奥马珠单抗是CRSwNP患者的一种新的治疗选择。本研究的目的是评估奥马珠单抗（抗IgE抗体）治疗CRSwNP患者的疗效和安全性。
基于从CRSwNP患者病历中提取的数据，评估奥马珠单抗的疗效和不良反应。每月对患者进行疗效和不良反应评估。通过视觉模拟量表（VAS）评估鼻漏、鼻后滴漏、打喷嚏、嗅觉和鼻塞症状的治疗效果，采用鼻窦结局测试-22（SNOT-22）和鼻阻塞症状评估（NOSE）评分。
17例CRSwNP患者组成了我们的队列。平均（标准差）年龄、体重和总IgE水平分别为41.9（9.4）岁、78.6（15）kg和198.8（169.2）IU/mL。3例患者合并轻度哮喘，6例合并中度哮喘，1例合并重度哮喘。奥马珠单抗治疗的平均（标准差）持续时间和息肉切除次数分别为9.2（13.3）个月和2.9（1.5）次。所有患者至少接受过一次息肉手术。奥马珠单抗治疗使所有鼻窦结局参数均显著改善，无论是否合并哮喘的亚组均如此。奥马珠单抗治疗在最后一次就诊日期相对于基线的中位数变化如下：SNOT-22评分从98降至19，NOSE评分从100降至20，鼻后滴漏、鼻漏、鼻塞、嗅觉和打喷嚏的VAS评分分别从8降至2、8降至2、10降至3、10降至2、6降至1（P < 0.001）。患者在奥马珠单抗治疗期间未出现不良反应。
奥马珠单抗对难治性CRSwNP合并或不合并哮喘的患者是一种有效的治疗方法。
