Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological Therapy
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory disorder of the upper airways, severely impacting quality of life. Dupilumab, targeting type 2 inflammatory pathways, is effective in managing severe, uncontrolled CRSwNP. However, the comparative accuracy of endoscopic s...
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2025-04-01
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| author | Giuseppe Roccuzzo Tommaso Saccardo Sonny Zampollo Nicola Tessari Alessandro Fontana Paolo Manildo Bruno Scarpa Piero Nicolai Giancarlo Ottaviano |
| author_facet | Giuseppe Roccuzzo Tommaso Saccardo Sonny Zampollo Nicola Tessari Alessandro Fontana Paolo Manildo Bruno Scarpa Piero Nicolai Giancarlo Ottaviano |
| author_sort | Giuseppe Roccuzzo |
| collection | DOAJ |
| description | Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory disorder of the upper airways, severely impacting quality of life. Dupilumab, targeting type 2 inflammatory pathways, is effective in managing severe, uncontrolled CRSwNP. However, the comparative accuracy of endoscopic scoring systems in monitoring therapeutic response to dupilumab remains unclear. This study compared the accuracy of the nasal polyp score (NPS) and the modified Lund–Kennedy endoscopic score (M-LKS) in assessing dupilumab response. Methods: A retrospective cohort analysis included 66 severe CRSwNP patients treated with dupilumab at Padua University. Endoscopic scores (NPS and M-LKS), patient-reported outcome mesures (PROMs), and clinician-reported outcome measures (CROMs), including peak nasal inspiratory flow (PNIF) and the Sniffin’ Sticks test, were evaluated at baseline and over 24 months. Results: Both NPS and M-LKS showed significant reductions over time (<i>p</i> < 0.001), significantly correlating with PNIF (<i>p</i> < 0.001). Given time and patient, PNIF emerged to be the only covariate related to endoscopic scores. No significant differences were observed between NPS and M-LKS regarding clinical outcome associations, suggesting equivalent accuracy. PNIF was identified as a critical predictor of endoscopic improvement, highlighting its clinical utility. These findings reinforce the role of standardized endoscopic metrics in assessing the efficacy of biologic therapies for CRSwNP. |
| format | Article |
| id | doaj-art-7cbe86e529784e23aabc3c5491b9a2e6 |
| institution | DOAJ |
| issn | 2076-3417 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
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| series | Applied Sciences |
| spelling | doaj-art-7cbe86e529784e23aabc3c5491b9a2e62025-08-20T02:58:43ZengMDPI AGApplied Sciences2076-34172025-04-01159487310.3390/app15094873Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological TherapyGiuseppe Roccuzzo0Tommaso Saccardo1Sonny Zampollo2Nicola Tessari3Alessandro Fontana4Paolo Manildo5Bruno Scarpa6Piero Nicolai7Giancarlo Ottaviano8Department of Neurosciences, Otolaryngology Section, University of Padova, 35128 Padova, ItalyDepartment of Neurosciences, Otolaryngology Section, University of Padova, 35128 Padova, ItalyDepartment of Neurosciences, Otolaryngology Section, University of Padova, 35128 Padova, ItalyDepartment of Neurosciences, Otolaryngology Section, University of Padova, 35128 Padova, ItalyDepartment of Neurosciences, Otolaryngology Section, University of Padova, 35128 Padova, ItalyDepartment of Statistical Sciences, University of Padova, 35121 Padova, ItalyDepartment of Statistical Sciences, University of Padova, 35121 Padova, ItalyDepartment of Neurosciences, Otolaryngology Section, University of Padova, 35128 Padova, ItalyDepartment of Neurosciences, Otolaryngology Section, University of Padova, 35128 Padova, ItalyChronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory disorder of the upper airways, severely impacting quality of life. Dupilumab, targeting type 2 inflammatory pathways, is effective in managing severe, uncontrolled CRSwNP. However, the comparative accuracy of endoscopic scoring systems in monitoring therapeutic response to dupilumab remains unclear. This study compared the accuracy of the nasal polyp score (NPS) and the modified Lund–Kennedy endoscopic score (M-LKS) in assessing dupilumab response. Methods: A retrospective cohort analysis included 66 severe CRSwNP patients treated with dupilumab at Padua University. Endoscopic scores (NPS and M-LKS), patient-reported outcome mesures (PROMs), and clinician-reported outcome measures (CROMs), including peak nasal inspiratory flow (PNIF) and the Sniffin’ Sticks test, were evaluated at baseline and over 24 months. Results: Both NPS and M-LKS showed significant reductions over time (<i>p</i> < 0.001), significantly correlating with PNIF (<i>p</i> < 0.001). Given time and patient, PNIF emerged to be the only covariate related to endoscopic scores. No significant differences were observed between NPS and M-LKS regarding clinical outcome associations, suggesting equivalent accuracy. PNIF was identified as a critical predictor of endoscopic improvement, highlighting its clinical utility. These findings reinforce the role of standardized endoscopic metrics in assessing the efficacy of biologic therapies for CRSwNP.https://www.mdpi.com/2076-3417/15/9/4873CRSwNPLund–Kennedy scorenasal polyp scoreNPSnasal endoscopydupilumab |
| spellingShingle | Giuseppe Roccuzzo Tommaso Saccardo Sonny Zampollo Nicola Tessari Alessandro Fontana Paolo Manildo Bruno Scarpa Piero Nicolai Giancarlo Ottaviano Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological Therapy Applied Sciences CRSwNP Lund–Kennedy score nasal polyp score NPS nasal endoscopy dupilumab |
| title | Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological Therapy |
| title_full | Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological Therapy |
| title_fullStr | Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological Therapy |
| title_full_unstemmed | Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological Therapy |
| title_short | Comparison of Modified Lund–Kennedy Endoscopic Score and Nasal Polyp Score in the Follow-Up of Patients with Severe Uncontrolled CRSwNP During Biological Therapy |
| title_sort | comparison of modified lund kennedy endoscopic score and nasal polyp score in the follow up of patients with severe uncontrolled crswnp during biological therapy |
| topic | CRSwNP Lund–Kennedy score nasal polyp score NPS nasal endoscopy dupilumab |
| url | https://www.mdpi.com/2076-3417/15/9/4873 |
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