Dupilumab improves sense of smell and clinical outcomes in patients with severe chronic rhinosinusitis with nasal polyps with anosmia.

Autor:	Lane AP; Division of Rhinology, Sinus and Skull Base Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Mullol J; Hospital Clínic, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Spain., Hopkins C; Department of Otorhinolaryngology, King's College London, London, UK., Fokkens WJ; Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, The Netherlands., Lee SE; Division of Otolaryngology - Head and Neck Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Msihid J; Sanofi, Gentilly, France., Nash S; Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA., Sacks H; Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA., Borsos K; Sanofi, Cambridge, MA, USA., Kamat S; Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA., Rowe PJ; Sanofi, Bridgewater, NJ, USA., Deniz Y; Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA., Jacob-Nara JA; Sanofi, Bridgewater, NJ, USA.
Jazyk:	angličtina
Zdroj:	Current medical research and opinion [Curr Med Res Opin] 2024 Dec 14, pp. 1-7. Date of Electronic Publication: 2024 Dec 14.
DOI:	10.1080/03007995.2024.2434083
Abstrakt:	Objective: Loss of sense of smell is a cardinal symptom of chronic rhinosinusitis with nasal polyps (CRSwNP) and significantly impacts health-related quality-of-life. Dupilumab significantly improved smell outcomes (loss of smell [LoS] score; University of Pennsylvania Smell Identification Test [UPSIT]) versus placebo in the phase 3 SINUS-24/-52 studies (clinicaltrials.gov, NCT02898454/NCT02912468) in patients with severe CRSwNP. This post hoc analysis investigated the effect of dupilumab on olfaction using UPSIT smell impairment categories. Methods: Patients with baseline smell impairment (UPSIT ≤34/≤33 [women/men; score range 0-40] AND LoS score ≥1 [0-3] AND smell/taste item of the 22-item Sinonasal Outcome Test >0 [SNOT-22; 0-5]) treated with dupilumab 300 mg or placebo once every 2 weeks on background intranasal corticosteroids were analyzed. Results: Of 724 patients, 665 (91.9%) had smell impairment at baseline; most had anosmia (UPSIT 0-18) (dupilumab/placebo: 80.9%/79.8%). At week 24, the proportion of dupilumab-treated patients with anosmia decreased to 28.5%, while 14.9% achieved normosmia; most placebo-group patients (79.2%) remained anosmic and only 1.2% achieved normosmia (odds ratio = 17.3; 95% confidence interval = 5.1-59.0; p <.0001); results were similar at week 52. Improvements in Nasal Polyp Score, nasal congestion, and SNOT-22 total score were moderately correlated with improvements in UPSIT at weeks 24 and 52 (r = -.38 to -.50). Conclusion: Most patients with severe CRSwNP had anosmia at baseline. Dupilumab treatment significantly improved smell versus placebo, with 14.9% achieving normosmia by week 24. There was a trend for better clinical outcomes in patients with greater smell improvement.
Databáze:	MEDLINE
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