Maza-Solano Juan, Aguilar-Cantador Juan, Noguerol-Pérez María Dolores, Sánchez-Torices María Soledad, Martínez-Martínez María Jesús, Gámiz-Maroto María José
Unidad de Rinología y Cirugía de base de cráneo anterior, Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena de Sevilla, Departamento de cirugía de la Universidad de Sevilla, Sevilla, Spain.
Unidad de Rinología, Hospital Universitario Reina Sofía, Córdoba, Spain.
Acta Otorrinolaringol Esp (Engl Ed). 2025 Jan-Feb;76(1):58-64. doi: 10.1016/j.otoeng.2024.08.001. Epub 2024 Sep 19.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by nasal obstruction, reduced sense of smell, rhinorrhea, and facial pain for more than 12 weeks, significantly affecting quality of life (QoL), especially in patients with NSAID-exacerbated respiratory disease (NERD). Initial treatment includes intranasal corticosteroids and nasal irrigations, followed by systemic corticosteroids (SC) in severe cases, as well as endoscopic sinus surgery (ESS) and biological agents. Mepolizumab, a monoclonal antibody against IL-5, has been shown to reduce eosinophilic inflammation in CRSwNP. This study evaluates the improvement in quality of life of patients with CRSwNP treated with mepolizumab before December 2023, recorded by the RINOSUR group. A retrospective observational multicenter cohort study is presented in adult patients with severe asthma and concomitant CRSwNP, treated with mepolizumab 100 mg. Variables such as sex, asthma, allergies, NERD, corticosteroid dependence, and serum eosinophil count were recorded. All patients underwent nasal endoscopy and completed the SNOT22 questionnaire. Therapeutic response was evaluated at 12 months. Out of 143 patients recruited, only 28.6% had the necessary data. 61% were women with a mean age of 55 years. All were corticosteroid-dependent and had required at least one ESS. A 22% reduction in SC cycles was observed, and no patient required revision surgery in the 12 months following treatment. The SNOT22 score was reduced by 53 points, and serum eosinophilia also showed a significant decrease. Mepolizumab is effective in treating severe uncontrolled CRSwNP, improving QoL and reducing dependence on systemic corticosteroids. Its activity is monitored by peripheral blood eosinophilia. Consistency in data collection is crucial to evaluate efficacy and manage the disease.
伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）的特征为鼻塞、嗅觉减退、流涕和面部疼痛超过12周，严重影响生活质量（QoL），尤其是在非甾体抗炎药加重的呼吸道疾病（NERD）患者中。初始治疗包括鼻用糖皮质激素和鼻腔冲洗，严重病例随后使用全身糖皮质激素（SC），以及内镜鼻窦手术（ESS）和生物制剂。美泊利单抗是一种抗白细胞介素-5单克隆抗体，已被证明可减轻CRSwNP中的嗜酸性粒细胞炎症。本研究评估了2023年12月之前接受美泊利单抗治疗的CRSwNP患者的生活质量改善情况，由RINOSUR组记录。一项回顾性观察性多中心队列研究纳入了患有重度哮喘并伴有CRSwNP的成年患者，给予100mg美泊利单抗治疗。记录了性别、哮喘、过敏、NERD、糖皮质激素依赖和血清嗜酸性粒细胞计数等变量。所有患者均接受了鼻内镜检查并完成了SNOT22问卷。在12个月时评估治疗反应。在招募的143例患者中，只有28.6%有必要的数据。61%为女性，平均年龄55岁。所有患者均依赖糖皮质激素，且至少需要一次ESS。观察到SC周期减少了22%，并且在治疗后的12个月内没有患者需要再次手术。SNOT22评分降低了53分，血清嗜酸性粒细胞增多也显著下降。美泊利单抗在治疗严重未控制的CRSwNP方面有效，可改善QoL并减少对全身糖皮质激素的依赖。其活性通过外周血嗜酸性粒细胞增多来监测。数据收集的一致性对于评估疗效和管理疾病至关重要。
