Sima Yutong, Zhang Jing, Zheng Ming, Zhao Yan, Wang Xiangdong, Zhang Luo
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Beijing Laboratory of Allergic Diseases, Beijing Municipal Education Commission and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.
World Allergy Organ J. 2023 Nov 29;16(12):100846. doi: 10.1016/j.waojou.2023.100846. eCollection 2023 Dec.
Both revision surgery and omalizumab are recommended therapies for the treatment of recurrent chronic rhinosinusitis with nasal polyps (CRSwNP) and can improve patients' clinical symptoms and quality of life (QoL). The aim of this study was to compare the improvement in sinus-related symptoms, QoL, economic cost, and duration cost between treatment with revision-surgery and treatment with omalizumab.
This was a prospective study of patients with recurrent CRSwNP. All patients were asked to complete a 22-item sino-nasal outcome test (SNOT-22), a visual analog scale (VAS), and a 36-item short-form (SF-36) questionnaire at baseline and 6 months after the treatments. Patients were required to document economic costs and duration costs within 6 months and report them at each visit.
A total of 44 patients who received the treatment of revision surgery or omalizumab were enrolled in this study. After six months of treatment, the improvements in total SNOT-22 and SF-36 in 8 domains were not different between the 2 treatments. The improvements in rhinologic symptoms, extranasal rhinologic symptoms, and ear/facial symptoms according to the SNOT-22 ( value = 0.0288, 0.0016, and 0.0347, respectively) and the improvements in nasal congestion, loss of smell, and overall symptoms assessed by the VAS ( value = 0.0057, 0.0206, and 0.0122, respectively) were better in the revision surgery group than in the omalizumab group. The economic cost and the total duration cost were obviously lower in the omalizumab group (¥18836 and 1 day) than in the revision surgery group (¥29824 and 23 days).
Both revision surgery and omalizumab treatments can improve the clinical symptoms and QoL of patients with recurrent CRSwNP. Patients who underwent revision surgery experienced better improvement in sinus-related symptoms. However, omalizumab treatment clearly showed a benefit in terms of economic cost and duration cost of disease-related care.
翻修手术和奥马珠单抗均为复发性慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)的推荐治疗方法,均可改善患者的临床症状和生活质量(QoL)。本研究旨在比较翻修手术治疗与奥马珠单抗治疗在鼻窦相关症状改善、生活质量、经济成本和病程成本方面的差异。
这是一项针对复发性CRSwNP患者的前瞻性研究。所有患者均被要求在基线时以及治疗后6个月完成一份22项的鼻鼻窦结局测试(SNOT-22)、视觉模拟量表(VAS)和一份36项的简短形式(SF-36)问卷。患者需记录6个月内的经济成本和病程成本,并在每次就诊时报告。
本研究共纳入44例接受翻修手术或奥马珠单抗治疗的患者。治疗6个月后,两种治疗方法在SNOT-22总分及SF-36的8个领域的改善情况无差异。根据SNOT-22,翻修手术组在鼻科症状、鼻外鼻科症状和耳/面部症状方面的改善(P值分别为0.0288、0.0016和0.0347)以及通过VAS评估的鼻塞、嗅觉丧失和总体症状的改善(P值分别为0.0057、0.0206和0.0122)均优于奥马珠单抗组。奥马珠单抗组的经济成本和总病程成本(分别为18836元及1天)明显低于翻修手术组(分别为29824元及23天)。
翻修手术和奥马珠单抗治疗均可改善复发性CRSwNP患者的临床症状和生活质量。接受翻修手术的患者在鼻窦相关症状方面改善更好。然而,奥马珠单抗治疗在疾病相关护理的经济成本和病程成本方面明显更具优势。