Department of Otorhinolaryngology, Head and Neck Surgery, Carl-von-Ossietzky University of Oldenburg, Oldenburg, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, University of Lubeck, Lubeck, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University of Lubeck, Lubeck, Germany.
Rhinology. 2023 Jun 1;61(3):203-213. doi: 10.4193/Rhin22.469.
Dupilumab, an IL-4/13 receptor inhibitor, is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP).
We evaluated the effectiveness and safety of dupilumab for CRSwNP based on retrospective 12-month follow-up data of 41 patients. We analysed nasal endoscopy scores, patient-reported outcome measures (PROMs), 12-item SniffinSticks odor identification test (SSIT-12), total serum IgE, serum Eosinophilic Cationic Protein (ECP), and total blood eosinophil count (BEC). We performed statistical analysis using non-parametric ANOVA-type models and Spearman's correlation.
At month 1, endoscopy scores, PROMs and SSIT-12 showed meaningful improvements that were maintained until month 12. Initial elevations in both median ECP and BECs returned to near baseline levels by month 12. The percentage of patients withBEC ≤ 0.6 remained increased at month 12 (42.1%) compared to baseline (19.5%). Total serum IgE levels decreased progressively and correlated with nasal polyp scores at month 12. "Adequate response" was reached in 86.8% of our cohort.
Our data suggest that dupilumab is effective for the treatment of CRSwNP. The potential for short- and long-term BEC elevations in some CRSwNP patients should be carefully monitored.
白细胞介素 4/13 受体抑制剂度普利尤单抗获批用于治疗未控制的慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）。
我们基于 41 例患者的 12 个月回顾性随访数据评估了度普利尤单抗治疗 CRSwNP 的有效性和安全性。我们分析了鼻内镜评分、患者报告的结局测量（PROMs）、12 项鼻闻测试（SSIT-12）、总血清 IgE、血清嗜酸性粒细胞阳离子蛋白（ECP）和总血嗜酸性粒细胞计数（BEC）。我们使用非参数 ANOVA 型模型和 Spearman 相关性进行了统计分析。
在第 1 个月，内镜评分、PROMs 和 SSIT-12 均显示出有意义的改善，且这些改善一直持续到第 12 个月。初始 ECP 和 BEC 的中位数升高在第 12 个月时恢复到接近基线水平。第 12 个月时，BEC≤0.6 的患者比例（42.1%）仍高于基线时（19.5%）。总血清 IgE 水平逐渐下降，与第 12 个月时的鼻息肉评分相关。我们队列中的 86.8%达到了“充分应答”。
我们的数据表明，度普利尤单抗对 CRSwNP 的治疗有效。在一些 CRSwNP 患者中，BEC 短时间和长时间升高的可能性应仔细监测。
