Kim Jiyeon, Kim Do Hyun, Hwang Se Hwan
Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Rhinol. 2023 Jul;30(2):62-68. doi: 10.18787/jr.2023.00029. Epub 2023 Jul 28.
Evidence bearing on the safety and efficacy of dupilumab treatment for chronic rhinosinusitis with nasal polyps (CRSwNP) has recently been presented by researchers from various institutions. Therefore, we compared the safety and efficacy of dupilumab treatment to those of endoscopic sinus surgery.
The PubMed, Scopus, Embase, Web of Science, and Cochrane databases were searched independently by two authors from the dates of their inception to December 2022. We retrieved the clinical results of CRSwNP patients after dupilumab administration, including changes in patient symptoms and the effects on the quality of life, and compared the results of dupilumab (treatment group) to those of endoscopic sinus surgery (control group).
Eight articles (1,251 patients) were ultimately included. Dupilumab significantly improved nasal symptoms (nasal congestion) (mean difference [MD], -1.4433; 95% confidence interval [CI], -1.7233 to -1.1632; I=94.2%), the visual analog sinusitis score (MD, -5.0506; 95% CI, -5.4744 to -4.6267; I=84.0%), olfactory function (standardized MD, 1.2691; 95% CI, 1.1549 to 1.3833; I=18.4%), the quality of life (SNOT-22 score) (MD, -34.4941; 95% CI, -39.4187 to -29.5695; I=90.8%), the Lund-Mackay computed tomography score (MD, -7.2713; 95% CI, -8.9442 to -5.5984; I=87.7%), and the nasal polyp score (MD, -3.1021; 95% CI, -3.7066 to -2.4977; I=95.6%) at about 12 months after treatment compared to the pretreatment values. Compared to endoscopic sinus surgery, dupilumab similarly improved olfactory function (MD, 1.9849; 95% CI, -1.6190 to 5.5888; I=0.0%) but was less effective in terms of reducing the SNOT-22 score (MD, 3.8472; 95% CI, 1.9872 to 5.7073; I=96.7%) and reducing nasal congestion (MD, 0.6519; 95% CI, 0.5619 to 0.7420; I=97.7%).
Dupilumab reduced subjective symptom scores and improved the quality of life and objective measures of progression compared to the preoperative values.
来自不同机构的研究人员近期公布了有关度普利尤单抗治疗伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）的安全性和有效性的证据。因此，我们比较了度普利尤单抗治疗与鼻内镜手术的安全性和有效性。
两位作者分别独立检索了PubMed、Scopus、Embase、Web of Science和Cochrane数据库，检索时间从各数据库创建之日至2022年12月。我们获取了度普利尤单抗给药后CRSwNP患者的临床结果，包括患者症状的变化及其对生活质量的影响，并将度普利尤单抗组（治疗组）的结果与鼻内镜手术组（对照组）的结果进行比较。
最终纳入8篇文章（共1251例患者）。与治疗前值相比，度普利尤单抗在治疗约12个月后显著改善了鼻症状（鼻塞）（平均差[MD]，-1.4433；95%置信区间[CI]，-1.7233至-1.1632；I²=94.2%）、视觉模拟鼻窦炎评分（MD，-5.0506；95%CI，-5.4744至-4.6267；I²=84.0%）、嗅觉功能（标准化MD，1.2691；95%CI，1.1549至1.3833；I²=18.4%）、生活质量（SNOT-22评分）（MD，-34.4941；95%CI，-39.4187至-29.5695；I²=90.8%）、Lund-Mackay计算机断层扫描评分（MD，-7.2713；95%CI，-8.9442至-5.5984；I²=87.7%）以及鼻息肉评分（MD，-3.1021；95%CI，-3.7066至-2.4977；I²=95.6%）。与鼻内镜手术相比，度普利尤单抗同样改善了嗅觉功能（MD，1.9849；95%CI，-1.6190至5.5888；I²=0.0%），但在降低SNOT-22评分（MD，3.8472；95%CI，1.9872至5.7073；I²=96.7%）和减轻鼻塞（MD，0.6519；95%CI，0.5619至0.7420；I²=97.7%）方面效果较差。
与术前值相比，度普利尤单抗降低了主观症状评分，改善了生活质量以及病情进展的客观指标。
