双鲁单抗作为术后短期辅助治疗慢性鼻炎合并鼻息肉的益处：初步研究

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2024-07-03 DOI:10.1002/lio2.1296

Pei-Wen Wu MD, Chi-Che Huang MD, Po-Hung Chang MD, Ta-Jen Lee MD, Chien-Chia Huang MD, PhD

{"title":"双鲁单抗作为术后短期辅助治疗慢性鼻炎合并鼻息肉的益处：初步研究","authors":"Pei-Wen Wu MD, Chi-Che Huang MD, Po-Hung Chang MD, Ta-Jen Lee MD, Chien-Chia Huang MD, PhD","doi":"10.1002/lio2.1296","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Recent evidence recommends the use of biologics in patients with severe uncontrolled type 2 chronic rhinosinusitis with nasal polyp (CRSwNP) owing to its propensity for recurrence after functional endoscopic sinus surgery (FESS). Among the type 2 biologics used for the treatment of nasal polyps, dupilumab (Dupi, anti-IL-4) exhibited superior efficacy and safety in indirect comparison studies.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>This study aimed to evaluate the objective and subjective outcomes of patients with CRSwNP treated with and without adjuvant Dupi therapy after FESS.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Adult patients with type 2 CRSwNP who underwent FESS with adjuvant Dupi after surgery were enrolled. A matched control group without adjuvant Dupi therapy were recruited during the same period. All patients underwent nasal endoscopy and completed the sinonasal outcome test-22 questionnaire evaluations at baseline and 3 months after surgery.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 10 patients who received postoperative adjuvant therapy with Dupi and 20 patients who underwent surgery only were included. Patients with add-on Dupi therapy had significantly higher eosinophil cationic protein levels in the serum, eosinophil counts in peripheral blood, prevalence of asthma, and nasal polyp score at baseline. Both treatments were effective in reducing the patient's symptoms by SNOT-22 at 3 months postoperatively. However, patients with adjuvant Dupi therapy exhibited significantly better endoscopic scores than those with surgery only (<i>p</i> = .022).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Surgery plays an important role in treating patients with CRSwNP, and adjuvant Dupi use may facilitate objective mucosal recovery postoperatively.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>4.</p>\n </section>\n </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 4","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.1296","citationCount":"0","resultStr":"{\"title\":\"The benefit of dupilumab as a postoperative short-term adjuvant therapy for chronic rhinosinusitis with nasal polyps: A preliminary study\",\"authors\":\"Pei-Wen Wu MD, Chi-Che Huang MD, Po-Hung Chang MD, Ta-Jen Lee MD, Chien-Chia Huang MD, PhD\",\"doi\":\"10.1002/lio2.1296\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Recent evidence recommends the use of biologics in patients with severe uncontrolled type 2 chronic rhinosinusitis with nasal polyp (CRSwNP) owing to its propensity for recurrence after functional endoscopic sinus surgery (FESS). Among the type 2 biologics used for the treatment of nasal polyps, dupilumab (Dupi, anti-IL-4) exhibited superior efficacy and safety in indirect comparison studies.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>This study aimed to evaluate the objective and subjective outcomes of patients with CRSwNP treated with and without adjuvant Dupi therapy after FESS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Adult patients with type 2 CRSwNP who underwent FESS with adjuvant Dupi after surgery were enrolled. A matched control group without adjuvant Dupi therapy were recruited during the same period. All patients underwent nasal endoscopy and completed the sinonasal outcome test-22 questionnaire evaluations at baseline and 3 months after surgery.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 10 patients who received postoperative adjuvant therapy with Dupi and 20 patients who underwent surgery only were included. Patients with add-on Dupi therapy had significantly higher eosinophil cationic protein levels in the serum, eosinophil counts in peripheral blood, prevalence of asthma, and nasal polyp score at baseline. Both treatments were effective in reducing the patient's symptoms by SNOT-22 at 3 months postoperatively. However, patients with adjuvant Dupi therapy exhibited significantly better endoscopic scores than those with surgery only (<i>p</i> = .022).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Surgery plays an important role in treating patients with CRSwNP, and adjuvant Dupi use may facilitate objective mucosal recovery postoperatively.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>4.</p>\\n </section>\\n </div>\",\"PeriodicalId\":48529,\"journal\":{\"name\":\"Laryngoscope Investigative Otolaryngology\",\"volume\":\"9 4\",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.1296\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope Investigative Otolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/lio2.1296\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope Investigative Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/lio2.1296","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

导言：由于功能性内窥镜鼻窦手术（FESS）后容易复发，最近的证据建议对严重未控制的 2 型慢性鼻炎伴鼻息肉（CRSwNP）患者使用生物制剂。在用于治疗鼻息肉的 2 型生物制剂中，杜必鲁单抗（Dupi，抗 IL-4）在间接对比研究中表现出更优越的疗效和安全性。目的本研究旨在评估在鼻息肉摘除术后接受或不接受杜比辅助治疗的 CRSwNP 患者的客观和主观疗效。方法入选的 2 型 CRSwNP 成人患者均接受了 FESS 术，术后进行了 Dupi 辅助治疗。同期还招募了未接受杜比辅助治疗的匹配对照组。所有患者均接受了鼻内窥镜检查，并在基线和术后 3 个月完成了鼻窦结果测试-22 问卷评估。结果共纳入了 10 名术后接受杜比辅助治疗的患者和 20 名仅接受手术治疗的患者。接受杜比辅助治疗的患者血清中嗜酸性粒细胞阳离子蛋白水平、外周血中嗜酸性粒细胞计数、哮喘发病率和鼻息肉评分均明显高于基线值。术后 3 个月时，两种疗法都能有效减轻患者的 SNOT-22 症状。然而，接受杜比辅助治疗的患者的内窥镜评分明显优于仅接受手术治疗的患者（p = .022）。结论手术在治疗 CRSwNP 患者中发挥着重要作用，而辅助使用杜比可促进术后粘膜的客观恢复。证据等级 4。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

The benefit of dupilumab as a postoperative short-term adjuvant therapy for chronic rhinosinusitis with nasal polyps: A preliminary study

Introduction

Recent evidence recommends the use of biologics in patients with severe uncontrolled type 2 chronic rhinosinusitis with nasal polyp (CRSwNP) owing to its propensity for recurrence after functional endoscopic sinus surgery (FESS). Among the type 2 biologics used for the treatment of nasal polyps, dupilumab (Dupi, anti-IL-4) exhibited superior efficacy and safety in indirect comparison studies.

Objective

This study aimed to evaluate the objective and subjective outcomes of patients with CRSwNP treated with and without adjuvant Dupi therapy after FESS.

Methods

Adult patients with type 2 CRSwNP who underwent FESS with adjuvant Dupi after surgery were enrolled. A matched control group without adjuvant Dupi therapy were recruited during the same period. All patients underwent nasal endoscopy and completed the sinonasal outcome test-22 questionnaire evaluations at baseline and 3 months after surgery.

Results

A total of 10 patients who received postoperative adjuvant therapy with Dupi and 20 patients who underwent surgery only were included. Patients with add-on Dupi therapy had significantly higher eosinophil cationic protein levels in the serum, eosinophil counts in peripheral blood, prevalence of asthma, and nasal polyp score at baseline. Both treatments were effective in reducing the patient's symptoms by SNOT-22 at 3 months postoperatively. However, patients with adjuvant Dupi therapy exhibited significantly better endoscopic scores than those with surgery only (p = .022).