Switching of biological therapy to dupilumab in comorbid patients with severe asthma and CRSwNP.

Autor: Rosso C; Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy. rosso.cecilia1@gmail.com.; Department of Otolaryngology, San Paolo Hospital, University of Milan, via di Rudinì 8, 20154, Milan, Italy. rosso.cecilia1@gmail.com., De Corso E; Unit of Otorhinolaryngology-Head and Neck Surgery, A. Gemelli Hospital Foundation IRCCS, 00168, Rome, Italy., Conti V; Otolaryngology Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy., Nitro L; Otolaryngology Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy., Saibene AM; Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy., Parazzini E; Pulmonology Department, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy., Rinaldo R; Pulmonology Department, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy., De Pascalis S; Pulmonology Department, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy., Arnone F; Otolaryngology Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy., Centanni S; Pulmonology Department, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy., Montuori C; Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168, Rome, Italy., D'Auria LM; Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168, Rome, Italy., Felisati G; Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy., Pipolo C; Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Jun; Vol. 281 (6), pp. 3017-3023. Date of Electronic Publication: 2024 Feb 12.
DOI: 10.1007/s00405-024-08461-y
Abstrakt: Purpose: Nowadays, several efficacious biologic drugs are used for severe asthma with or without chronic rhinosinusitis with nasal polyps (CRSwNP). However, it has been observed that not all comorbid patients (asthma/CRSwNP) receiving biologic treatment for asthma experience satisfactory control of both conditions equally.
Methods: We selected 20 patients who had both severe asthma and comorbid CRSwNP under biological treatment with benralizumab, omalizumab or mepolizumab with adequate control of asthma but inadequate control of nasal symptoms. Patients were switched to dupilumab and outcomes were evaluated at baseline (T0), at 3 months (T1), at 6 months (T2), at 12 months (T3) and finally at 18 months (T4). Data were collected at each time point including blood tests measuring eosinophil levels and total IgE, SNOT22, ACT, NPS score, rhinomanometry, olfactory testing, and nasal cytology.
Results: The results showed an overall improvement in all the outcomes. Peripheral eosinophilia was observed consistently with existing literature. All patients registered an improvement in sinonasal outcomes, while only one patient had a worsening of asthma. Three patients interrupted the therapy due to various causes: poor asthma control, onset of psoriasis and thrombocytopenia.
Conclusions: The response to a biologic treatment for CRSwNP control may be heterogenous and it seems that patients may benefit from switching improving control in equal measure in the upper and lower airway. Further studies to explore the endotype/phenotype which best fits with each biologic are mandatory to personalize the therapy.
(© 2024. The Author(s).)
Databáze: MEDLINE
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