Department of Pulmonary Medicine, Faculty of Medicine, Cairo University, Old Cairo, Cairo Governorate, Cairo, 4240310, Egypt.
Department of Internal Medicine, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, Saudi Arabia.
BMC Pulm Med. 2024 Jul 8;24(1):328. doi: 10.1186/s12890-024-03139-x.
This study's purposes were to evaluate the impact of biological therapies on outcomes in patients with severe asthma (SA) and chronic rhinosinusitis (CRS) and to compare these effects among those with NP (CRSwNP) versus those without NP (CRSsNP) in the "real-world" setting in Saudi Arabian patients.
From March to September 2022, a retrospective observational cohort study was undertaken at the severe asthma clinics of the Armed Forces Hospital-Southern Region (AFHSR) and King Khalid University Hospital, Abha, Saudi Arabia, to delineate the effects of dupilumab therapy. Outcomes were assessed, including clinical outcomes, FEV1, and laboratory findings before and one year after dupilumab. Post-therapy effects were compared between CRSwNP and CRSsNP.
Fifty subjects were enrolled, with a mean age of 46.56. There were 27 (54%) females and 23(46%) males. Significant improvements in clinical parameters (frequency of asthma exacerbations and hospitalizations, the use of OCs, anosmia, SNOTT-22, and the ACT), FEV1, and laboratory ones (serum IgE and eosinophilic count) were observed 6 and 12 months after using dupilumab (p < 0.001), respectively. However, after 12 months of dupilumab therapy, there were no significant differences between those with and without NP with regards to clinical (anosmia, ACT, and OCs use), laboratory (eosinophilic count, serum IgE level) parameters, and FEV1%.
Patients with CRS experienced significant improvements in clinical, FEV1, and laboratory outcomes after dupilumab therapy. However, these improvements were not maintained when comparing CRSwNP with CRSsNP. There were no significant differences between those with and without NP regarding ACT and OCs use or laboratory (eosinophilic count, serum IgE level) parameters. Further prospective multicenter studies are warranted.
本研究旨在评估生物疗法对沙特阿拉伯严重哮喘（SA）和慢性鼻-鼻窦炎（CRS）患者结局的影响，并在“真实世界”环境中比较伴有和不伴鼻息肉（CRSwNP）与不伴鼻息肉（CRSsNP）的患者之间的这些影响。
2022 年 3 月至 9 月，在沙特阿拉伯阿卜哈的武装部队医院南部地区（AFHSR）和 King Khalid 大学医院的严重哮喘诊所进行了一项回顾性观察队列研究，以描绘度普利尤单抗治疗的效果。评估了包括临床结局、FEV1 和治疗前后一年的实验室发现在内的结局。比较了 CRSwNP 和 CRSsNP 之间的治疗后效果。
共纳入 50 名患者，平均年龄为 46.56 岁。女性 27 名（54%），男性 23 名（46%）。使用度普利尤单抗后 6 和 12 个月，临床参数（哮喘加重和住院频率、OC 使用、嗅觉丧失、SNOTT-22 和 ACT）、FEV1 和实验室参数（血清 IgE 和嗜酸性粒细胞计数）均有显著改善（p<0.001）。然而，在使用度普利尤单抗治疗 12 个月后，伴有和不伴有 NP 的患者之间在临床（嗅觉丧失、ACT 和 OC 使用）、实验室（嗜酸性粒细胞计数、血清 IgE 水平）参数和 FEV1%方面均无显著差异。
CRS 患者在接受度普利尤单抗治疗后，在临床、FEV1 和实验室结局方面均有显著改善。然而，在比较 CRSwNP 与 CRSsNP 时，这些改善并未持续。伴有和不伴有 NP 的患者在 ACT 和 OC 使用或实验室（嗜酸性粒细胞计数、血清 IgE 水平）参数方面无显著差异。需要进一步进行前瞻性多中心研究。
