The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNP
Abstract Background Dupilumab significantly improves symptom control in chronic rhinosinusitis with nasal polyps (CRSwNP). Patients with large polyps at the initiation of treatment (total polyp score (TPS) ≥ 5) have been the focus in published studies. Patients with significant burden of disease but...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40463-023-00663-4 |
| _version_ | 1797689158694600704 |
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| author | Nicholas J. Campion Jonas Brugger Aldine Tu Victoria Stanek Faris F. Brkic Tina J. Bartosik David T. Liu Bruna S. Hoehl Katharina Gangl Julia Eckl-Dorna Sven Schneider |
| author_facet | Nicholas J. Campion Jonas Brugger Aldine Tu Victoria Stanek Faris F. Brkic Tina J. Bartosik David T. Liu Bruna S. Hoehl Katharina Gangl Julia Eckl-Dorna Sven Schneider |
| author_sort | Nicholas J. Campion |
| collection | DOAJ |
| description | Abstract Background Dupilumab significantly improves symptom control in chronic rhinosinusitis with nasal polyps (CRSwNP). Patients with large polyps at the initiation of treatment (total polyp score (TPS) ≥ 5) have been the focus in published studies. Patients with significant burden of disease but small polyps (TPS ≤ 4) have not yet been evaluated for clinical response. This study set out to evaluate the benefit of dupilumab treatment on cohorts of small (TPS ≤ 4) compared to large polyps (TPS ≥ 5). Furthermore, benefit of concomitant oral and/or nasal steroid therapy has been evaluated. Methods 97 patients with CRSwNP, who were begun on dupilumab between January 2020 and October 2021, were included. All patients were followed-up for 6 months. At each visit they underwent nasal endoscopy, smell identification tests and filled out validated patient questionnaires. Results Significant drops in TPS were seen in both patient groups after 6 months of therapy, dropping from a median score of 3 to 0 and from 6 to 2 in patients with small and large polyps respectively. Furthermore, a linear mixed model calculated a drop of 22% and 24% in TPS per month in patients with small and large polyps respectively with no significant difference in rate of decline. Finally the model showed that neither oral nor nasal steroids influenced the rate of response to dupilumab therapy. Conclusions Polyp size at the initiation of dupilumab therapy and whether patients continue to take steroid therapy does not appear to influence effectiveness of dupilumab treatment. |
| first_indexed | 2024-03-12T01:41:57Z |
| format | Article |
| id | doaj.art-e730ba670eb247d6bbd81c8bb7b22b86 |
| institution | Directory Open Access Journal |
| issn | 1916-0216 |
| language | English |
| last_indexed | 2024-03-12T01:41:57Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj.art-e730ba670eb247d6bbd81c8bb7b22b862023-09-10T11:20:06ZengBMCJournal of Otolaryngology - Head and Neck Surgery1916-02162023-09-0152111210.1186/s40463-023-00663-4The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNPNicholas J. Campion0Jonas Brugger1Aldine Tu2Victoria Stanek3Faris F. Brkic4Tina J. Bartosik5David T. Liu6Bruna S. Hoehl7Katharina Gangl8Julia Eckl-Dorna9Sven Schneider10Department of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaCenter for Medical Statistics, Informatics and Intelligent Systems, Medical University of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaDepartment of Otorhinolaryngology, Research Laboratories 8H, Medical University of Vienna, General Hospital of ViennaAbstract Background Dupilumab significantly improves symptom control in chronic rhinosinusitis with nasal polyps (CRSwNP). Patients with large polyps at the initiation of treatment (total polyp score (TPS) ≥ 5) have been the focus in published studies. Patients with significant burden of disease but small polyps (TPS ≤ 4) have not yet been evaluated for clinical response. This study set out to evaluate the benefit of dupilumab treatment on cohorts of small (TPS ≤ 4) compared to large polyps (TPS ≥ 5). Furthermore, benefit of concomitant oral and/or nasal steroid therapy has been evaluated. Methods 97 patients with CRSwNP, who were begun on dupilumab between January 2020 and October 2021, were included. All patients were followed-up for 6 months. At each visit they underwent nasal endoscopy, smell identification tests and filled out validated patient questionnaires. Results Significant drops in TPS were seen in both patient groups after 6 months of therapy, dropping from a median score of 3 to 0 and from 6 to 2 in patients with small and large polyps respectively. Furthermore, a linear mixed model calculated a drop of 22% and 24% in TPS per month in patients with small and large polyps respectively with no significant difference in rate of decline. Finally the model showed that neither oral nor nasal steroids influenced the rate of response to dupilumab therapy. Conclusions Polyp size at the initiation of dupilumab therapy and whether patients continue to take steroid therapy does not appear to influence effectiveness of dupilumab treatment.https://doi.org/10.1186/s40463-023-00663-4Chronic rhinosinusitisCRSwNPNasal polypAsthmaBiological treatment |
| spellingShingle | Nicholas J. Campion Jonas Brugger Aldine Tu Victoria Stanek Faris F. Brkic Tina J. Bartosik David T. Liu Bruna S. Hoehl Katharina Gangl Julia Eckl-Dorna Sven Schneider The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNP Journal of Otolaryngology - Head and Neck Surgery Chronic rhinosinusitis CRSwNP Nasal polyp Asthma Biological treatment |
| title | The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNP |
| title_full | The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNP |
| title_fullStr | The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNP |
| title_full_unstemmed | The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNP |
| title_short | The “real life” efficacy of dupilumab is independent of initial polyp size and concomitant steroids in CRSwNP |
| title_sort | real life efficacy of dupilumab is independent of initial polyp size and concomitant steroids in crswnp |
| topic | Chronic rhinosinusitis CRSwNP Nasal polyp Asthma Biological treatment |
| url | https://doi.org/10.1186/s40463-023-00663-4 |
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