Ottaviano Giancarlo, De Corso Eugenio, Cantone Elena, Ciofalo Andrea, Saccardo Tommaso, Bernardi Riccardo, Mairani Edoardo, Montuori Claudio, Roccuzzo Giuseppe, Soldati Livia, Randon Benedetto, Zampollo Sonny, Chicco Alessandra Di, Visconti Francesca, Scarpa Bruno, Nicolai Piero
Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy.
ENT Department of A. Gemelli Unversitary Hospital IRCCS, 00168 Rome, Italy.
J Pers Med. 2023 Jan 28;13(2):234. doi: 10.3390/jpm13020234.
Chronic rhinosinusitis with nasal polyps (CRSwNP) in the most severe forms is associated with a poor quality of life. Dupilumab has been suggested as an add-on treatment option for severe CRSwNP. Severe CRSwNP patients treated with dupilumab in different rhinological units were followed up at 1, 3, 6 and 12 months from the first administration and were considered for this study. At baseline (T0) and at each follow-up, patients underwent nasal endoscopy and completed the sinonasal outcome test (SNOT)-22, a visual analogue scale (VAS) for smell/nasal obstruction, peak nasal inspiratory flow (PNIF) and the Sniffin' Sticks identification test (SSIT). The aim of the present study was to evaluate the effects of dupilumab in patients with severe uncontrolled CRSwNP on recovering nasal obstruction and smell impairment. Moreover, the method between PNIF and SSIT with the highest correlation with patients' response to dupilumab was evaluated. One hundred forty-seven patients were included. All parameters improved during treatment ( < 0.001). At T0, no correlations were found between PNIF and nasal symptoms. Nevertheless, during the following evaluations significant correlations between PNIF changes and both nasal symptoms and NPS were observed ( < 0.05). At T0, SSIT did not correlate with SNOT-22. Similarly to PNIF, during the follow-up SSIT changes significantly correlated with nasal symptom and NPS ( < 0.05). Comparing PNIF and SSIT correlations with SNOT-22 and NPS, PNIF showed a higher correlation with both. Dupilumab improves nasal obstruction and the sense of smell. PNIF and SSIT are effective tools in monitoring patients' response to dupilumab.
最严重形式的慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）与生活质量差相关。度普利尤单抗已被建议作为重度CRSwNP的一种附加治疗选择。在不同鼻科单位接受度普利尤单抗治疗的重度CRSwNP患者，从首次给药起1、3、6和12个月进行随访，并纳入本研究。在基线（T0）和每次随访时，患者接受鼻内镜检查，并完成鼻窦结局测试（SNOT）-22、嗅觉/鼻塞视觉模拟量表（VAS）、鼻腔最大吸气流量（PNIF）和嗅觉棒识别测试（SSIT）。本研究的目的是评估度普利尤单抗对重度未控制的CRSwNP患者恢复鼻塞和嗅觉障碍的影响。此外，评估了与患者对度普利尤单抗反应相关性最高的PNIF和SSIT之间的方法。纳入了147例患者。治疗期间所有参数均有改善（<0.001）。在T0时，未发现PNIF与鼻部症状之间存在相关性。然而，在随后的评估中，观察到PNIF变化与鼻部症状和鼻息肉评分（NPS）之间存在显著相关性（<0.05）。在T0时，SSIT与SNOT-22不相关。与PNIF类似，在随访期间，SSIT变化与鼻部症状和NPS显著相关（<0.05）。比较PNIF和SSIT与SNOT-22和NPS的相关性，PNIF与两者的相关性更高。度普利尤单抗可改善鼻塞和嗅觉。PNIF和SSIT是监测患者对度普利尤单抗反应的有效工具。
