Yoon So Yeon, Cha HyunKyung, Hong Seung-No, Yang Min-Suk, Kim Dae Woo
Department of Otorhinolaryngology-Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Clin Exp Otorhinolaryngol. 2024 Nov;17(4):317-325. doi: 10.21053/ceo.2024.00233. Epub 2024 Oct 31.
This study evaluates the enduring efficacy and patient satisfaction of dupilumab with interdose interval adjustments based on the Sino-Nasal Outcome Test (SNOT-22) in chronic rhinosinusitis with nasal polyps (CRSwNP).
A retrospective analysis was conducted on 44 patients who had been treated with dupilumab for over 6 months. This study targeted individuals diagnosed with CRSwNP according to the 2020 edition of the European Position Paper on Rhinosinusitis and Nasal Polyps Criteria. The treatment involved an add-on dupilumab regimen, where the interdose interval was adjusted based on the SNOT-22 scores. Dosage adjustments were made such that patients with initial SNOT-22 scores greater than 40 were tapered to a target level of 20 or less. Similarly, for patients with initial scores of 40 or less, the treatment aimed for an improvement of 50% or more. At each visit, the effectiveness of the treatment was evaluated using SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire adapted from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4).
The adjustment of the interdose interval for dupilumab based on SNOT-22 scores demonstrated sustained improvements in patients' subjective symptoms, satisfaction, and NPS. The mean (standard deviation) SNOT-22 scores significantly decreased from 46.04 (22.30) to 14.72 (13.66) over 6 months (P<0.001). Similarly, NPS scores improved from 3.20 (2.24) to 1.72 (1.46) within the same period (P<0.001). Satisfaction scores, ranging from 0 to 5, consistently remained above 3.5 for up to 6 months (P=0.166). Additionally, there was a significant correlation between the improvement in the nasal symptom domain of the SNOT-22 scores and higher satisfaction scores.
Adjusting dupilumab dosing intervals based on SNOT-22 scores from the outset resulted in sustained efficacy and patient satisfaction in Korean patients with CRSwNP. This approach will meaningfully assist clinicians in determining the optimal dupilumab dosing interval.
本研究评估了在伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）患者中，基于鼻-鼻窦结局测试（SNOT-22）调整度普利尤单抗给药间隔后的持久疗效及患者满意度。
对44例接受度普利尤单抗治疗超过6个月的患者进行回顾性分析。本研究纳入了根据2020年版《欧洲鼻窦炎和鼻息肉立场文件》标准诊断为CRSwNP的个体。治疗采用度普利尤单抗附加治疗方案，根据SNOT-22评分调整给药间隔。进行剂量调整，使初始SNOT-22评分大于40的患者逐渐减量至目标水平20或更低。同样，对于初始评分40或更低的患者，治疗目标是改善50%或更多。每次就诊时，使用SNOT-22、鼻息肉评分（NPS）以及改编自药物治疗满意度问卷（TSQM v.1.4）的主观满意度问卷评估治疗效果。
基于SNOT-22评分调整度普利尤单抗的给药间隔显示，患者的主观症状、满意度和NPS持续改善。6个月内，平均（标准差）SNOT-22评分从46.04（22.30）显著降至14.72（13.66）（P<0.001）。同样，同期NPS评分从3.20（2.24）改善至1.72（1.46）（P<0.001）。满意度评分范围为0至5，在长达6个月的时间里始终保持在3.5以上（P=0.166）。此外，SNOT-22评分的鼻部症状领域改善与更高的满意度评分之间存在显著相关性。
从一开始就根据SNOT-22评分调整度普利尤单抗的给药间隔，在韩国CRSwNP患者中产生了持续疗效和患者满意度。这种方法将有效地帮助临床医生确定度普利尤单抗的最佳给药间隔。
