Dupilumab improves patient-reported outcomes in patients with chronic rhinosinusitis with nasal polyps and comorbid asthma
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory condition affecting the upper airways, with chronic symptoms such as nasal congestion, partial (hyposmia) or total (anosmia) loss of smell, anterior/posterior rhinorrhea, and mild facial pain.1 As many as 66% of patients with...
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Veröffentlicht in: | The journal of allergy and clinical immunology in practice (Cambridge, MA) MA), 2019-09, Vol.7 (7), p.2447-2449.e2 |
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Zusammenfassung: | Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory condition affecting the upper airways, with chronic symptoms such as nasal congestion, partial (hyposmia) or total (anosmia) loss of smell, anterior/posterior rhinorrhea, and mild facial pain.1 As many as 66% of patients with CRSwNP have comorbid asthma and suffer from more severe nasal obstruction, higher levels of lower airway inflammation, and worse asthma control than those without CRS.2,3 Thus, patients with CRSwNP and comorbid asthma have a high disease burden, seriously impacting health-related quality of life (HRQoL).2,3 Markers of type 2-mediated inflammation and antibody production (eg, IL-5, IgE) are associated with both CRSwNP and asthma pathogenesis.2 Dupilumab, a fully human VelocImmune-derived4,5 monoclonal antibody, blocks the shared receptor component for IL-4 and IL-13, thus inhibiting signaling of both IL-4 and IL-13, key drivers of type 2 diseases such as atopic dermatitis, asthma, and allergic rhinitis.6 In a 16-week phase 2a study in adults with CRSwNP refractory to intranasal corticosteroids (INCS), adding dupilumab to mometasone furoate nasal spray (MFNS) reduced nasal polyp burden versus MFNS alone and significantly improved nasal congestion and airflow, sense of smell, HRQoL, and other nasal symptoms.7 We present a subgroup analysis of patients with CRSwNP and comorbid asthma from this study, examining the effect of dupilumab on patient-reported outcomes (PROs) for CRSwNP and asthma, and inflammatory biomarkers. EQ-5D VAS provides a simple measure of the patient's self-rated health on a vertical virtual analog scale, with scores 0 to 100 mm (worst-best imaginable health state).8 SF-36 comprises 8 domains assessing physical functioning, social functioning, role limitations due to physical and emotional problems, mental health, energy/vitality, bodily pain, and general health perception. Two summary scores, the physical (PCS) and mental health component summary, are calculated by the aggregation of the 8 SF-36 subscales, to evaluate the physical and mental health, respectively (higher scores indicating better HRQoL).9 The effects of dupilumab on the individual ACQ-5 scores (woken at night by asthma, awake in morning with asthma symptoms, limited in activities, shortness of breath, wheezing time), as well as inflammatory biomarkers (eosinophils, eosinophil cationic protein, thymus and activation-regulated chemokine, IgE, and periostin), were also assessed. [.. |
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ISSN: | 2213-2198 2213-2201 2213-2201 |
DOI: | 10.1016/j.jaip.2019.03.023 |