Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis
Background: Eosinophilic otitis media (EOM) is a refractory condition associated with eosinophilic chronic rhinosinusitis and bronchial asthma. EOM is characterized by type-2 inflammation and is refractory to various treatments. We investigated the efficacy of dupilumab, interleukin-4 receptor alpha...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Allergology International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1323893023000382 |
| _version_ | 1797672093822746624 |
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| author | Daiki Nakashima Tsuguhisa Nakayama Syunsuke Minagawa Tetsuya Adachi Chieko Mitsuyama Yoko Shida Tsuneya Nakajima Shin-ichi Haruna Yoshinori Matsuwaki |
| author_facet | Daiki Nakashima Tsuguhisa Nakayama Syunsuke Minagawa Tetsuya Adachi Chieko Mitsuyama Yoko Shida Tsuneya Nakajima Shin-ichi Haruna Yoshinori Matsuwaki |
| author_sort | Daiki Nakashima |
| collection | DOAJ |
| description | Background: Eosinophilic otitis media (EOM) is a refractory condition associated with eosinophilic chronic rhinosinusitis and bronchial asthma. EOM is characterized by type-2 inflammation and is refractory to various treatments. We investigated the efficacy of dupilumab, interleukin-4 receptor alpha antagonist, for patients with EOM complicated by eosinophilic chronic rhinosinusitis (ECRS). Methods: Between April 2017 and April 2022, we treated 124 patients with dupilumab for refractory CRS or bronchial asthma. Of these, 14 had EOM concurrently, and 10 of them who had been treated for >6 months were included in our study. We retrospectively evaluated the efficacy of dupilumab by the amount of systemic corticosteroid used, the frequency of exacerbations, severity score of EOM, computed tomography (CT) score of temporal bones, and pure tone audiometry. We also enrolled 8 EOM patients without dupilumab treatment as a control group. Results: Dupilumab significantly improved the amount of systemic corticosteroid used and the frequency of exacerbation and compared with before dupilumab was used (p = 0.01 and <0.01, respectively). All patients could be weaned from systemic-corticosteroid therapy by 54 weeks of dupilumab use. The severity score of EOM and CT score for temporal bones were significantly lower than before the treatment (p = 0.01 and 0.01, respectively). Compared to the control group, the systemic corticosteroid used and severity scores were improved in the dupilumab group (p = 0.02 and < 0.01, respectively). Conclusions: Dupilumab could be used to wean patients from systemic corticosteroids with the improvement of severity score in EOM associated with ECRS and bronchial asthma. |
| first_indexed | 2024-03-11T21:25:04Z |
| format | Article |
| id | doaj.art-94c0351717c84119a87bb7c4898c9f4e |
| institution | Directory Open Access Journal |
| issn | 1323-8930 |
| language | English |
| last_indexed | 2024-03-11T21:25:04Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj.art-94c0351717c84119a87bb7c4898c9f4e2023-09-28T05:25:00ZengElsevierAllergology International1323-89302023-10-01724557563Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitisDaiki Nakashima0Tsuguhisa Nakayama1Syunsuke Minagawa2Tetsuya Adachi3Chieko Mitsuyama4Yoko Shida5Tsuneya Nakajima6Shin-ichi Haruna7Yoshinori Matsuwaki8Matsuwaki Clinic Shinagawa, Tokyo, Japan; Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, Japan; Department of Otorhinolaryngology and Head & Neck Surgery, Dokkyo Medical University, Tochigi, Japan; Corresponding author. Department of Otorhinolaryngology and Head & Neck Surgery, Dokkyo Medical University, 880 Kita-kobayashi, Mibu, Shimotsuga-gun, Tochigi 321-0293, Japan.Matsuwaki Clinic Shinagawa, Tokyo, Japan; Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, Japan; Musashino Allergy Clinic, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, Japan; Department of Otorhinolaryngology and Head & Neck Surgery, Dokkyo Medical University, Tochigi, JapanMatsuwaki Clinic Shinagawa, Tokyo, Japan; Corresponding author.Matsuwaki Clinic Shinagawa, 6-7-110 Kita-shinagawa, Shinagawa-ku, Tokyo 141-0001, Japan.Background: Eosinophilic otitis media (EOM) is a refractory condition associated with eosinophilic chronic rhinosinusitis and bronchial asthma. EOM is characterized by type-2 inflammation and is refractory to various treatments. We investigated the efficacy of dupilumab, interleukin-4 receptor alpha antagonist, for patients with EOM complicated by eosinophilic chronic rhinosinusitis (ECRS). Methods: Between April 2017 and April 2022, we treated 124 patients with dupilumab for refractory CRS or bronchial asthma. Of these, 14 had EOM concurrently, and 10 of them who had been treated for >6 months were included in our study. We retrospectively evaluated the efficacy of dupilumab by the amount of systemic corticosteroid used, the frequency of exacerbations, severity score of EOM, computed tomography (CT) score of temporal bones, and pure tone audiometry. We also enrolled 8 EOM patients without dupilumab treatment as a control group. Results: Dupilumab significantly improved the amount of systemic corticosteroid used and the frequency of exacerbation and compared with before dupilumab was used (p = 0.01 and <0.01, respectively). All patients could be weaned from systemic-corticosteroid therapy by 54 weeks of dupilumab use. The severity score of EOM and CT score for temporal bones were significantly lower than before the treatment (p = 0.01 and 0.01, respectively). Compared to the control group, the systemic corticosteroid used and severity scores were improved in the dupilumab group (p = 0.02 and < 0.01, respectively). Conclusions: Dupilumab could be used to wean patients from systemic corticosteroids with the improvement of severity score in EOM associated with ECRS and bronchial asthma.http://www.sciencedirect.com/science/article/pii/S1323893023000382Eosinophilic otitis mediaEosinophilic chronic rhinosinusitisBronchial asthmaDupilumabCorticosteroid |
| spellingShingle | Daiki Nakashima Tsuguhisa Nakayama Syunsuke Minagawa Tetsuya Adachi Chieko Mitsuyama Yoko Shida Tsuneya Nakajima Shin-ichi Haruna Yoshinori Matsuwaki Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis Allergology International Eosinophilic otitis media Eosinophilic chronic rhinosinusitis Bronchial asthma Dupilumab Corticosteroid |
| title | Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis |
| title_full | Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis |
| title_fullStr | Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis |
| title_full_unstemmed | Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis |
| title_short | Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis |
| title_sort | dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis |
| topic | Eosinophilic otitis media Eosinophilic chronic rhinosinusitis Bronchial asthma Dupilumab Corticosteroid |
| url | http://www.sciencedirect.com/science/article/pii/S1323893023000382 |
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