Boiko N V, Stagnieva I V, Lodochkina O E, Kurbatova N V
Rostov State Medical University of the Ministry of Health of Russia, Rostov-on-Don, Russia.
Southern Federal University, Rostov-on-Don, Russia.
Vestn Otorinolaringol. 2023;88(4):46-53. doi: 10.17116/otorino20228804146.
Chronic rhinosinusitis (CRS) with nasal polyps is the most severe form of inflammatory diseases of the paranasal sinuses, especially in combination with comorbid asthma. A new avenue for the personalized treatment of severe forms of eosinophilic inflammation are biologics based on humanized monoclonal antibodies.
To study the effectiveness of targeted therapy in patients with CRS with nasal polyps and comorbid asthma.
19 patients selected for biological therapy according to international criteria were studied. The patients were randomly divided into 2 groups. The first group included 10 patients treated with dupilumab. Dupilumab was administered subcutaneously 300 mg every 2 weeks for 24 weeks. Group 2 included 9 patients treated with reslizumab for severe eosinophilic asthma with comorbid CRS with nasal polyps. Reslizumab was administered intravenously 3 mg/kg body weight once every 4 weeks for 24 weeks. These patients constituted the comparison group. Both drugs are used in treatment of eosinophilic inflammation but have different biological targets.
Comparative analysis of the dynamics of the main indicators characterizing the clinical course of CRS with nasal polyps and asthma (SNOT-22, control of asthma symptoms - ACT, the results of SCT of the paranasal sinuses according to the Lund-Mackay score) revealed a positive trend in patients of both groups, more pronounced in patients receiving dupilumab.
Changes in CT of the paranasal sinuses, characterized by the Lund-Mackay score, the results of SNOT-22 and ACT are the most demonstrative and can be used to assess the results of treatment with biologics in patients with chronic rhinosinusitis with nasal polyps.
伴有鼻息肉的慢性鼻-鼻窦炎（CRS）是鼻窦炎性疾病最严重的形式，尤其是合并哮喘时。基于人源化单克隆抗体的生物制剂为重度嗜酸性粒细胞炎症的个性化治疗开辟了新途径。
研究靶向治疗对伴有鼻息肉和合并哮喘的CRS患者的有效性。
根据国际标准选择19例接受生物治疗的患者进行研究。患者随机分为2组。第一组包括10例接受度普利尤单抗治疗的患者。度普利尤单抗每2周皮下注射300mg，共24周。第二组包括9例接受瑞利珠单抗治疗的伴有鼻息肉的CRS合并重度嗜酸性粒细胞哮喘患者。瑞利珠单抗每4周静脉注射3mg/kg体重，共24周。这些患者构成对照组。两种药物均用于治疗嗜酸性粒细胞炎症，但具有不同的生物学靶点。
对表征伴有鼻息肉的CRS和哮喘临床病程的主要指标（SNOT-22、哮喘症状控制-ACT、根据Lund-Mackay评分的鼻窦SCT结果）的动态变化进行比较分析，发现两组患者均呈阳性趋势，在接受度普利尤单抗治疗的患者中更为明显。
以Lund-Mackay评分、SNOT-22和ACT结果为特征的鼻窦CT变化最具指示性，可用于评估生物制剂治疗伴有鼻息肉的慢性鼻-鼻窦炎患者的疗效。
