The effect of biological agent use on symptoms in patients diagnosed with NSAID-Exacerbated Respiratory Disease (NERD)

Abstract

Introduction

In recent years, biological approaches targeting Type 2 cytokines have emerged as potential treatment options in NSAID-Exacerbated Respiratory Disease (NERD) patients. In this study, we aimed to evaluate the clinical efficacy of omalizumab and mepolizumab in NERD patients with severe asthma via nasal and respiratory symptoms, pulmonary functions and exacerbation status.

Methods

The study was conducted retrospectively in adults with NERD who were initiated on omalizumab and mepolizumab and had been treated with a biologic agent for at least 1 year. Data on lung function test results, eosinophil counts, asthma exacerbation rates, asthma control levels, and Sino-Nasal Outcome Test-22 scores before starting the biological agent were compared with data obtained 1 year after starting the biological treatment.

Results

The study included data from 18 NERD patients, 10 of whom received omalizumab and 8 of whom received mepolizumab. In the NERD group receiving omalizumab, statistically significant changes were observed in terms of clinical improvement in FEV1 values, mean eosinophil counts, annual exacerbation rates, asthma control and SNOT-22 scores after biologic treatment. In patients receiving mepolizumab, significant decreases were found in mean eosinophil counts, annual exacerbation rates and SNOT-22 scores after biologic treatment compared to pre-treatment. Daily oral corticosteroid requirements were significantly reduced in patients receiving both omalizumab and mepolizumab.

Conclusion

In conclusion, the present study results reveal that both omalizumab and mepolizumab treatments are effective in controlling nasal symptoms, reducing the number of asthma exacerbations, and reducing the need for low-dose maintenance steroids in severe asthmatics with NERD.