度普利尤单抗可改善鼻息肉慢性鼻-鼻窦炎患者的睡眠质量。

Dupilumab improves sleep quality in chronic rhinosinusitis with nasal polyps.

机构信息

Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, Turin, Italy.

出版信息

Am J Otolaryngol. 2024 Jul-Aug;45(4):104310. doi: 10.1016/j.amjoto.2024.104310. Epub 2024 Apr 19.

DOI:10.1016/j.amjoto.2024.104310

PMID:38677148

Abstract

PURPOSE

Chronic rhinosinusitis with nasal polyps (CRSwNP) often alters sleep quality. Dupilumab emerged as an innovative and effective therapy for refractory/recurrent severe CRSwNP. The aim of this observational retrospective study was to evaluate the sleep quality in patients with CRSwNP who underwent treatment with dupilumab.

MATERIALS AND METHODS

Forty-five patients treated with dupilumab for CRSwNP were enrolled. Clinical parameters (age, sex, comorbidities, Nasal Polyp Score - NPS, Asthma Control Test - ACT), nasal cytology, quality of life (Sino Nasal Outcome Test 22 - SNOT-22), sleep quality (Pittsburgh Sleep Quality Index - PSQI, Epworth Sleepiness Scale - ESS), and risk of sleep apnea (STOP-BANG) were recorded before treatment (T0), and after 3 (T1), 6 (T2), and 12 months (T3).

RESULTS

NPS, ACT and SNOT-22 total score improved during treatment (p < 0.05). Meanwhile, all sleep parameters evaluated with SNOT-22, ESS and PSQI improved over time (p < 0.001), expect for PSQI Use of sleeping medications. Indeed, sleep drugs are rarely used before and during the treatment. The global sleep quality was classified as poor in 88.9 % of cases at T0 and decreased to 5.7 % at T3. A high risk of sleep apnea was revealed by the STOP-BANG in 68.9 % of cases at T0 and 2.8 % of patient at T3 (p < 0.001).

CONCLUSIONS

Dupilumab improves the sleep quality and reduce the risk of sleep apnea in patients with severe CRSwNP. Its favorable effect occurs within 3 months and is maintained during the treatment.

摘要

目的

伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）常导致睡眠质量下降。度普利尤单抗是一种治疗难治性/复发性重度 CRSwNP 的创新且有效的药物。本观察性回顾性研究旨在评估接受度普利尤单抗治疗的 CRSwNP 患者的睡眠质量。

材料和方法

共纳入 45 例接受度普利尤单抗治疗的 CRSwNP 患者。记录临床参数（年龄、性别、合并症、鼻息肉评分-NPS、哮喘控制测试-ACT）、鼻细胞学、生活质量（22 项鼻窦结局测试-SNOT-22）、睡眠质量（匹兹堡睡眠质量指数-PSQI、Epworth 嗜睡量表-EESS）和睡眠呼吸暂停风险（STOP-BANG），在治疗前（T0）以及治疗后 3 个月（T1）、6 个月（T2）和 12 个月（T3）时进行评估。

结果

NPS、ACT 和 SNOT-22 总分在治疗期间得到改善（p<0.05）。同时，所有用 SNOT-22、EESS 和 PSQI 评估的睡眠参数都随着时间的推移而改善（p<0.001），除了 PSQI 中使用睡眠药物这一项。事实上，在治疗前后很少使用睡眠药物。在 T0 时，88.9%的病例总体睡眠质量被归类为差，而在 T3 时则降至 5.7%。T0 时 68.9%的病例存在睡眠呼吸暂停高风险，而 T3 时则降至 2.8%（p<0.001）。