Use of Nasal Nitric Oxide to Compare Endoscopic Sinus Surgery Versus Dupilumab: An Exploratory Real-World Comparison.

IF 0.7
Daniel J Lee, Giovanni Paoletti, Gaia Giulietti, Elysia Grose, Roberto Pinto, Enrico Heffler, John M Lee
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Abstract

Objective: To compare the outcomes of endoscopic sinus surgery (ESS) and dupilumab using nasal nitric oxide (nNO) as a biomarker of mucosal health, Lund-Kennedy endoscopy score (LKES), and Sino-Nasal Outcome Test-22 (SNOT-22).

Methods: A prospective observational cohort of chronic rhinosinusitis with nasal polyposis (CRSwNP) patients who underwent ESS followed by standard postoperative therapy was compared with another prospective cohort of CRSwNP patients who received dupilumab. In addition to baseline characteristics, nNO production, LKES, and SNOT-22 levels were compared between the 2 cohorts at the 1st month and 6th month posttreatment.

Results: A total of 28 and 37 patients were included in the ESS cohort and the dupilumab group, respectively. At the 1stmonth and 6th month posttreatment, nNO levels were comparable between 2 groups. Compared to baseline, the ESS cohort showed increased nNO levels at 1st month posttreatment, while the dupilumab group did not. At the 6th month posttreatment, both groups exhibited a significant increase in nNO levels. Similar trend was observed in LKES. SNOT-22 decreased at the 1st month and 6th month posttreatment compared with that in baseline.

Conclusion: ESS and dupilumab confer comparable benefits in terms of nNO changes, symptoms, and endoscopy findings at the 6th month posttreatment. ESS may result in more rapid improvement in the outcomes than in dupilumab as evidenced by the 1 month posttreatment values.

使用鼻腔一氧化氮比较内窥镜鼻窦手术与杜匹单抗:一个探索性的现实世界比较。
目的:比较鼻内窥镜鼻窦手术(ESS)和dupilumab的结果,使用鼻一氧化氮(nNO)作为粘膜健康的生物标志物,隆德-肯尼迪内窥镜评分(LKES)和Sino-Nasal Outcome Test-22 (SNOT-22)。方法:对慢性鼻窦炎合并鼻息肉(CRSwNP)患者进行ESS术后标准治疗的前瞻性观察队列与另一组接受dupilumab治疗的CRSwNP患者进行比较。除了基线特征外,还比较了治疗后第1个月和第6个月两组患者的nNO生成、LKES和SNOT-22水平。结果:ESS队列和dupilumab组分别纳入28例和37例患者。治疗后第1个月和第6个月,两组间nNO水平比较具有可比性。与基线相比,ESS队列在治疗后1个月显示nNO水平升高,而dupilumab组没有。治疗后6个月,两组nNO水平均显著升高。在LKES中也观察到类似的趋势。治疗后第1个月和第6个月SNOT-22较基线下降。结论:ESS和dupilumab在治疗后6个月的nNO变化、症状和内窥镜检查结果方面具有相当的益处。治疗后1个月的数据证明,ESS可能比杜匹单抗更快地改善预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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