Department of Otolaryngology, University of California, San Diego, School of Medicine, 200 West Arbor Drive MC 8654, San Diego, CA 92103, United States of America.
Harvard Medical School, 45 Francis Street, Boston, MA 02115, United States of America.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104368. doi: 10.1016/j.amjoto.2024.104368. Epub 2024 May 1.
We sought to determine if chronic rhinosinusitis patients treated with endoscopic sinus surgery have fewer episodes of acute rhinosinusitis (ARS) post treatment compared to CRS patients treated with biologics alone.
We analyzed the electronic medical records of 213 adults with CRS who initiated treatment with either dupilumab or mepolizumab in calendar years 2016-2021 (CRS-biologics) group and a matched group with tissue eosinophilia who had undergone endoscopic sinus surgery (CRS-ESS) group. For each cohort, the medical record was reviewed to determine the number of ARS episodes for 12 months before and after treatment. Similarly, the number of antibiotic prescriptions was determined for each cohort in the 12 months after initiation of biologic therapy or ESS.
There was no statistically significant difference in ARS episodes before initiation of between the CRS-biologic and CRS-ESS cohorts (0.38 versus 0.44 episodes per year, respectively; p = 0.323). In contrast, after initiation of therapy, the CRS-biologics group had a significantly reduced frequency of acute rhinosinusitis episodes versus the CRS-ESS group (0.11 versus 0.25 episodes per year; p = 0.001). Finally, the utilization of oral antibiotics in the 12 months after among those treated with biologics versus those treated with ESS was not significantly different (0.04 versus 0.08, respectively; p = 0.109).
For CRS patients, treatment with dupilumab or mepolizumab significantly reduced the number of ARS episodes compared to CRS treated with ESS. Biologics appear to work as well as ESS in the control of ARS episodes after treatment for CRS.
我们旨在确定与单独接受生物制剂治疗的慢性鼻-鼻窦炎（CRS）患者相比，接受内镜鼻窦手术（ESS）治疗的 CRS 患者在治疗后急性鼻-鼻窦炎（ARS）发作次数是否更少。
我们分析了 2016-2021 年接受度普利尤单抗或美泊利珠单抗治疗的 213 例成人 CRS 患者（CRS-生物制剂组）和接受 ESS 治疗的组织嗜酸性粒细胞增多患者（CRS-ESS 组）的电子病历。对于每个队列，回顾病历以确定治疗前和治疗后 12 个月的 ARS 发作次数。同样，在开始生物治疗或 ESS 后 12 个月内，确定每个队列的抗生素处方数量。
CRS-生物制剂组和 CRS-ESS 组在开始治疗前的 ARS 发作次数无统计学差异（分别为 0.38 和 0.44 次/年；p=0.323）。相比之下，在开始治疗后，CRS-生物制剂组的急性鼻-鼻窦炎发作频率明显低于 CRS-ESS 组（分别为 0.11 和 0.25 次/年；p=0.001）。最后，与 ESS 治疗相比，生物治疗组在治疗后 12 个月内使用口服抗生素的频率无显著差异（分别为 0.04 和 0.08；p=0.109）。
对于 CRS 患者，与接受 ESS 治疗的 CRS 患者相比，接受度普利尤单抗或美泊利珠单抗治疗可显著减少 ARS 发作次数。生物制剂在治疗 CRS 后的 ARS 发作控制方面似乎与 ESS 一样有效。
