Two-Year Data of Tapered Dupilumab Shows High Effectiveness in Chronic Rhinosinusitis with Nasal Polyps With Nonsteroidal Anti-inflammatory Drug-Exacerbated Respiratory Disease

IF 12 1区医学 Q1 ALLERGY

Allergy Pub Date : 2025-05-16 DOI:10.1111/all.16579

H. B. E. Elzinga, J. J. Otten, M. E. Cornet, A. B. Rinia, R. J. L. Van Der Lans, W. J. Fokkens, S. Reitsma, PolyREG Consortium

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引用次数: 0

Abstract

Background

Patients with Non-steroidal anti-inflammatory drugs (NSAID)-Exacerbated Respiratory Disease (N-ERD) can suffer from difficult-to-treat primary diffuse type 2 chronic rhinosinusitis with nasal polyps (CRSwNP). This study evaluates dupilumab effectiveness and dose tapering in CRSwNP patients with N-ERD compared to those without.

Methods

A real-world prospective cohort with CRSwNP patients, with N-ERD or without (CRSwNP-NOS; not otherwise specified), aged ≥ 18 treated with dupilumab 300 mg subcutaneously every 2 weeks. In case of clinical control, the interdose interval was prolonged every 6 months with steps of 2 weeks. (Clinical) data were collected at baseline, 24 weeks, and 2 years of treatment.

Results

Most baseline characteristics, including Nasal Polyp Score (NPS), Sino-Nasal Outcome Test-22 (SNOT-22), and Sniffin′ sticks-12 test (SSIT-12) were comparable between groups (N-ERD n = 105, CRSwNP-NOS n = 293). There was a higher prevalence (91.5% vs. 71.1%, p < 0.001) but comparable control of asthma in N-ERD patients (asthma control test [ACT]: N-ERD 66.7% less controlled/uncontrolled vs. CRSwNP-NOS 58.3%, p = 0.21). All outcomes improved significantly with dupilumab treatment at 24 weeks and remained improved after 2 years, without intergroup differences (median scores at 24 weeks for N-ERD patients vs. CRSwNP-NOS, respectively: NPS: 2 vs. 1, p = 0.65; SNOT-22: 18 vs. 19, p = 0.27; SSIT-12: 7 vs. 8, p = 0.02; ACT: 21 vs. 22, p = 0.11). Dose tapering was possible in the majority of patients, with almost half at an 8–12 weeks interval in both groups after 2 years.

Conclusion

Dupilumab shows comparable effectiveness and taper feasibility between CRSwNP N-ERD patients and CRSwNP-NOS patients.

Abstract Image

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两年的减量Dupilumab数据显示对非甾体抗炎药加重呼吸系统疾病的CRSwNP有效。

背景：非甾体抗炎药（NSAID）加重呼吸系统疾病（N-ERD）患者可出现难以治疗的原发性弥漫性2型慢性鼻窦炎伴鼻息肉（CRSwNP）。本研究评估了合并N-ERD的CRSwNP患者与未合并N-ERD的CRSwNP患者相比dupilumab的有效性和剂量递减。方法：一项现实世界的前瞻性队列研究，包括有N-ERD或没有CRSwNP的患者(CRSwNP- nos；未另有说明)，年龄≥18岁，每2周皮下注射dupilumab 300 mg。在临床对照的情况下，每6个月延长一次给药间隔，每2周延长一次。（临床）数据收集于基线、治疗24周和治疗2年。结果：大多数基线特征，包括鼻息肉评分（NPS）、鼻内镜预后测试-22 （SNOT-22）和嗅嗅棒-12测试（SSIT-12），组间具有可比性（n - erd n = 105, CRSwNP-NOS n = 293）。结论：Dupilumab在CRSwNP N-ERD患者和CRSwNP- nos患者中具有相当的疗效和逐渐减少的可行性。

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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来源期刊

Allergy 医学-过敏

CiteScore

26.10

自引率

9.70%

发文量

393

审稿时长

2 months

期刊介绍： Allergy is an international and multidisciplinary journal that aims to advance, impact, and communicate all aspects of the discipline of Allergy/Immunology. It publishes original articles, reviews, position papers, guidelines, editorials, news and commentaries, letters to the editors, and correspondences. The journal accepts articles based on their scientific merit and quality. Allergy seeks to maintain contact between basic and clinical Allergy/Immunology and encourages contributions from contributors and readers from all countries. In addition to its publication, Allergy also provides abstracting and indexing information. Some of the databases that include Allergy abstracts are Abstracts on Hygiene & Communicable Disease, Academic Search Alumni Edition, AgBiotech News & Information, AGRICOLA Database, Biological Abstracts, PubMed Dietary Supplement Subset, and Global Health, among others.