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度普利尤单抗诱导伴鼻息肉和合并哮喘的慢性鼻-鼻窦炎缓解:一项24个月的研究

Dupilumab-Induced Remission in Chronic Rhinosinusitis with Nasal Polyps and Comorbid Asthma: A 24-Month Study.

作者信息

Tajiri Tomoko, Suzuki Motohiko, Nishiyama Hirono, Ozawa Yoshiyuki, Amakusa Yuki, Suzuki Tatsuro, Ito Keima, Mori Yuta, Fukumitsu Kensuke, Fukuda Satoshi, Kanemitsu Yoshihiro, Uemura Takehiro, Ohkubo Hirotsugu, Takemura Masaya, Ito Yutaka, Oguri Tetsuya, Niimi Akio

机构信息

Department of Respiratory Medicine, Allergy and Clinical Immunology, Graduate School of Medical Sciences, Nagoya City University, Aichi 467-8601, Japan.

Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medical Sciences, Nagoya City University, Aichi 467-8601, Japan.

出版信息

J Clin Med. 2025 May 23;14(11):3654. doi: 10.3390/jcm14113654.

Abstract

When considering the effects of dupilumab on severe chronic rhinosinusitis with nasal polyps (CRSwNPs), dupilumab is expected to achieve CRSwNPs remission. The aim of this study was to assess the rate of remission of CRSwNPs with comorbid asthma and its predictors on a 24-month course of dupilumab. Adult patients with severe CRSwNPs and comorbid asthma who had completed a 24-month course of dupilumab were included in this post hoc analysis. The primary outcome was the rate of CRSwNPs remission at 12 and 24 months of dupilumab. The secondary outcome was to identify factors associated with CRSwNPs remission at 12 and 24 months. Based on the European criteria and a previous definition, remission was defined as the absence of symptoms, improved quality of life, no need for surgery, no exacerbations, recovery of olfactory function, and inactive disease by nasal endoscopy for ≥12 months. A rigorous six-component remission, including olfactory testing, was initially used. Of 16 patients, 4 (25%) and 5 (31%) achieved six-component remission of CRSwNPs at 12 and 24 months, respectively. Patients with shorter disease duration and better olfactory function at baseline achieved six-component remission of CRSwNPs more frequently than those without at 24 months (both < 0.05). Remission of severe CRSwNPs with comorbid asthma is attainable with a 24-month course of dupilumab.

摘要

在考虑度普利尤单抗对伴有鼻息肉的重度慢性鼻-鼻窦炎(CRSwNPs)的影响时,预计度普利尤单抗可实现CRSwNPs缓解。本研究的目的是评估在度普利尤单抗24个月疗程中,合并哮喘的CRSwNPs的缓解率及其预测因素。本事后分析纳入了完成度普利尤单抗24个月疗程的重度CRSwNPs合并哮喘的成年患者。主要结局是度普利尤单抗治疗12个月和24个月时CRSwNPs的缓解率。次要结局是确定与12个月和24个月时CRSwNPs缓解相关的因素。根据欧洲标准和先前的定义,缓解定义为无症状、生活质量改善、无需手术、无病情加重、嗅觉功能恢复以及鼻内镜检查显示疾病静止≥12个月。最初采用了包括嗅觉测试在内的严格的六成分缓解标准。16例患者中,分别有4例(25%)和5例(31%)在12个月和24个月时实现了CRSwNPs的六成分缓解。疾病持续时间较短且基线嗅觉功能较好的患者在24个月时比未达到这些条件的患者更频繁地实现CRSwNPs的六成分缓解(均P<0.05)。度普利尤单抗24个月疗程可使合并哮喘的重度CRSwNPs实现缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9929/12156171/95b865901e25/jcm-14-03654-g001.jpg

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