A new study presented at the 2023 American Rhinologic Society, Combined Otolaryngology Spring Meeting (ARS-COSM) held in Boston, Massachusetts, May 3-5, suggested that the use of dupilumab leads to improvement in the quality of life, particularly in the loss of smell, for patients with chronic rhinosinusitis with nasal polyps (CRSwNP).
CRSwNP is a type 2-mediated inflammatory disease of the nasal cavity and paranasal sinuses, resulting in nasal congestion, loss of smell, and other symptoms. Anosmia or loss of smell is one of the most significant and difficult-to-treat symptoms for patients with CRSwNP. Dupilumab is an FDA-approved inflammatory inhibitor for treating allergic diseases, including CRSwNP.
A team of researchers from San Camillo Forlanini Hospital, Rome, Italy, reported their preliminary experience in evaluating quality-of-life outcomes in CRSwNP patients treated with dupilumab. The study conducted at the Rhino-Allergology, and the Pneumology Unit of San Camillo Forlanini Hospital enrolled 37 patients with CRSwNP treated with dupilumab. A dedicated collection form using a clinician-reported outcome and two PROM questionnaires, namely a visual analogue scale (VAS) and the Sino nasal outcome test (SNOT-22), was developed to monitor the patient’s compliance with therapy and the associated clinical outcomes.
Study results showed that the majority of patients (78%) exhibited concomitant asthma, followed by allergy (76%), GORD (54%), smoke (43%), aspirin sensitivity (35%), atopic dermatitis (19%) and immune diseases (11%). Moreover, 97% of all patients, before starting the biological therapy, underwent surgical management. “Monitoring our patients, we have noticed a considerable respiratory gain associated with a nasal symptoms improvement on the VAS scale. We further found an improvement of Nasal Polyp Score and SNOT-22 score,” the author added.
The authors highlighted that although dupilumab has shown improvement in managing CRSwNP, further studies are needed to develop specialized use guidelines and identify the accurate clinical indications for biologics therapy in CRSwNP patients. “Based on our preliminary observations, quality of life has shown an improvement, especially in the loss of smell,” the authors concluded.
The authors of the study include Stefano Millarelli, MD; Antonella Loperfido, MD; Gianluca Bellocchi, MD, from the Department of Otolaryngology, San Camillo Forlanini Hospital, Rome, Italy; Federica Millarelli, MD; from the Department of Infectious and Tropical Diseases, Sapienza University, Rome, Italy, and Loreta Di Michele, MD; from the Department of Pulmonary Interstitial Diseases, San Camillo Forlanini Hospital, Rome, Italy.
Reference:
Millarelli S, Loperfido A, Millarelli F, Di Michele L, Bellocchi, G. Biologics in the management of chronic rhinosinusitis with nasal polyps: a real-life experience. ARS-COSM, May 4-5, 2023.