Wang Huikang, Xu Xinjun, Lu Zhaoyang, Zhai Zhaoxue, Shao Liting, Song Xicheng, Zhang Yu
Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai, QingdaoUniversity, China.
Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China.
Eur Arch Otorhinolaryngol. 2025 Feb;282(2):559-569. doi: 10.1007/s00405-024-08903-7. Epub 2024 Aug 26.
Currently, there is a debate around the use of biological agents in the treatment of chronic sinusitis with nasal polyps. Therefore, this study's purpose was to assess the effectiveness of various biologics in the treatment of chronic rhinosinusitis with nasal polyps.
A systematic and manual search was conducted for all relevant studies from inception to December 20, 2023. Two independent authors carried out the search, screening, assessment, and data extraction. Network meta-analysis was conducted using STATA 14 software.
Our analysis includes a comprehensive set of 19 studies. These studies compared the efficacy of four distinct biologic treatments. The results of reticulated Meta-analysis showed that Dupilumab (MD = - 1.85, 95% CI: - 2.47, - 1.24), Omalizumab (MD = - 1.30, 95% CI: - 1.90, - 0.70), Benralizumab (MD = - 0.84, 95% CI: - 1.66, - 0.03) and Mepolizumab (MD = - 1.48, 95% CI: - 2.22, - 0.74) were superior to placebo from the nasal polyp score(NPS), Dupilumab (MD = - 12.56, 95% CI: - 22.49,- 2.63) was superior to placebo from the Sino-Nasal Outcome Test-22(SNOT-22)score, and Dupilumab (MD = - 0.84, 95% CI: - 1.08, - 0.59) and Omalizumab (RR = - 0.51, 95% CI: - 0.83, - 0.19) were superior to placebo from the nasal congestion severity(NCS). In terms of cumulative sorting under the surface of the curve (SUCRA) values, Dupilumab was the best performer in the NPS (0.92), SNOT-22 score (0.70), and NCS (0.93); Four different biologics outperformed placebo in the NPS, SNOT-22 score, and NCS.
In patients with CRSwNP, based on the efficacy (NPS, (SNOT-22) score, NCS) and, dupilumab is the most efficacious for CRSwNP.
目前，关于生物制剂在治疗伴有鼻息肉的慢性鼻窦炎中的应用存在争议。因此，本研究的目的是评估各种生物制剂在治疗伴有鼻息肉的慢性鼻-鼻窦炎中的有效性。
对从研究起始至2023年12月20日的所有相关研究进行了系统和人工检索。由两名独立作者进行检索、筛选、评估和数据提取。使用STATA 14软件进行网状Meta分析。
我们的分析纳入了一组全面的19项研究。这些研究比较了四种不同生物治疗的疗效。网状Meta分析结果显示，从鼻息肉评分（NPS）来看，度普利尤单抗（MD = -1.85，95%CI：-2.47，-1.24）、奥马珠单抗（MD = -1.30，95%CI：-1.90，-0.70）、贝那利珠单抗（MD = -0.84，95%CI：-1.66，-0.03）和美泊利珠单抗（MD = -1.48，95%CI：-2.22，-0.74）优于安慰剂；从鼻窦-鼻腔结局测试-22（SNOT-22）评分来看，度普利尤单抗（MD = -12.56，95%CI：-22.49，-2.63）优于安慰剂；从鼻充血严重程度（NCS）来看，度普利尤单抗（MD = -0.84，95%CI：-1.08，-0.59）和奥马珠单抗（RR = -0.51，95%CI：-0.83，-0.19）优于安慰剂。就曲线下累积排序（SUCRA）值而言，度普利尤单抗在NPS（0.92）、SNOT-22评分（0.70）和NCS（0.93）方面表现最佳；四种不同的生物制剂在NPS、SNOT-22评分和NCS方面均优于安慰剂。
在慢性鼻-鼻窦炎伴鼻息肉患者中，基于疗效（NPS、SNOT-22评分、NCS），度普利尤单抗对慢性鼻-鼻窦炎伴鼻息肉最为有效。
