Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis
Background: Eosinophilic chronic rhinosinusitis (ECRS) is a subgroup of chronic rhinosinusitis with nasal polyps (CRSwNP), which is a disease characterized by eosinophilic infiltration of the sinonasal mucosa. Few studies that reported the effect of dupilumab on CRSwNP focused on a single phenotype...
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Elsevier
2025-05-01
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| Series: | Journal of Allergy and Clinical Immunology: Global |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S277282932500013X |
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| author | Daiki Nakashima, MD Tsuguhisa Nakayama, MD, PhD Shunsuke Minagawa, MD, PhD Tetsuya Adachi, MD, PhD Chieko Mitsuyama, MD Yoko Shida, MD Tsuneya Nakajima, MD, PhD Shin-ichi Haruna, MD, PhD Yoshinori Matsuwaki, MD, PhD |
| author_facet | Daiki Nakashima, MD Tsuguhisa Nakayama, MD, PhD Shunsuke Minagawa, MD, PhD Tetsuya Adachi, MD, PhD Chieko Mitsuyama, MD Yoko Shida, MD Tsuneya Nakajima, MD, PhD Shin-ichi Haruna, MD, PhD Yoshinori Matsuwaki, MD, PhD |
| author_sort | Daiki Nakashima, MD |
| collection | DOAJ |
| description | Background: Eosinophilic chronic rhinosinusitis (ECRS) is a subgroup of chronic rhinosinusitis with nasal polyps (CRSwNP), which is a disease characterized by eosinophilic infiltration of the sinonasal mucosa. Few studies that reported the effect of dupilumab on CRSwNP focused on a single phenotype of CRSwNP, such as ECRS. Objectives: This study aimed to determine the effectiveness of dupilumab in ECRS with postoperative recurrence. Methods: We retrospectively enrolled 107 patients and assessed the effectiveness of dupilumab by various clinical outcomes. We performed multivariable analysis on nasal polyp score (NPS) and computed tomography score and a meta-analysis of the effect of dupilumab on chronic rhinosinusitis regarding improvement in the NPS. Results: At 12 months of dupilumab treatment, there were 65 patients (60.7%) in the excellent response group and 42 (39.3%) in the moderate response group. Nasal polyps had disappeared in 91 patients (85.9%) at 12 months, and there was improvement in all end points; 104 patients (97.2%) were able to eliminate systemic corticosteroid therapy. In the multivariate analysis, male sex was significantly associated with patients who did not show an improvement to 0 in the NPS and computed tomography score (odds ratios: 7.58 and 2.45; P = .01 and P = .04, respectively). The meta-analysis showed that dupilumab treatment resulted in a trend toward better improvement in the NPS (mean difference = −5.41) than previously reported results. Conclusions: Dupilumab shows effectiveness in treating ECRS and could serve as an alternative therapeutic option to systemic corticosteroids. This effectiveness may be further enhanced by limiting the target population to recurrent ECRS. |
| format | Article |
| id | doaj-art-a24f94f540154ca49914c1d282633df2 |
| institution | Kabale University |
| issn | 2772-8293 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Allergy and Clinical Immunology: Global |
| spelling | doaj-art-a24f94f540154ca49914c1d282633df22025-02-09T05:01:45ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-05-0142100412Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitisDaiki Nakashima, MD0Tsuguhisa Nakayama, MD, PhD1Shunsuke Minagawa, MD, PhD2Tetsuya Adachi, MD, PhD3Chieko Mitsuyama, MD4Yoko Shida, MD5Tsuneya Nakajima, MD, PhD6Shin-ichi Haruna, MD, PhD7Yoshinori Matsuwaki, MD, PhD8Matsuwaki Clinic Shinagawa, Tokyo, Japan; Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, Japan; Department of Otorhinolaryngology and Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan; Corresponding author: Tsuguhisa Nakayama, MD, PhD, Department of Otorhinolaryngology and Head and 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, Musashino, JapanMatsuwaki Clinic Shinagawa, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, JapanMatsuwaki Clinic Shinagawa, Tokyo, Japan; Department of Otorhinolaryngology and Head and Neck Surgery, Dokkyo Medical University, Tochigi, JapanMatsuwaki Clinic Shinagawa, Tokyo, JapanBackground: Eosinophilic chronic rhinosinusitis (ECRS) is a subgroup of chronic rhinosinusitis with nasal polyps (CRSwNP), which is a disease characterized by eosinophilic infiltration of the sinonasal mucosa. Few studies that reported the effect of dupilumab on CRSwNP focused on a single phenotype of CRSwNP, such as ECRS. Objectives: This study aimed to determine the effectiveness of dupilumab in ECRS with postoperative recurrence. Methods: We retrospectively enrolled 107 patients and assessed the effectiveness of dupilumab by various clinical outcomes. We performed multivariable analysis on nasal polyp score (NPS) and computed tomography score and a meta-analysis of the effect of dupilumab on chronic rhinosinusitis regarding improvement in the NPS. Results: At 12 months of dupilumab treatment, there were 65 patients (60.7%) in the excellent response group and 42 (39.3%) in the moderate response group. Nasal polyps had disappeared in 91 patients (85.9%) at 12 months, and there was improvement in all end points; 104 patients (97.2%) were able to eliminate systemic corticosteroid therapy. In the multivariate analysis, male sex was significantly associated with patients who did not show an improvement to 0 in the NPS and computed tomography score (odds ratios: 7.58 and 2.45; P = .01 and P = .04, respectively). The meta-analysis showed that dupilumab treatment resulted in a trend toward better improvement in the NPS (mean difference = −5.41) than previously reported results. Conclusions: Dupilumab shows effectiveness in treating ECRS and could serve as an alternative therapeutic option to systemic corticosteroids. This effectiveness may be further enhanced by limiting the target population to recurrent ECRS.http://www.sciencedirect.com/science/article/pii/S277282932500013XEosinophilic chronic rhinosinusitisdupilumabcorticosteroidmeta-analysis |
| spellingShingle | Daiki Nakashima, MD Tsuguhisa Nakayama, MD, PhD Shunsuke Minagawa, MD, PhD Tetsuya Adachi, MD, PhD Chieko Mitsuyama, MD Yoko Shida, MD Tsuneya Nakajima, MD, PhD Shin-ichi Haruna, MD, PhD Yoshinori Matsuwaki, MD, PhD Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis Journal of Allergy and Clinical Immunology: Global Eosinophilic chronic rhinosinusitis dupilumab corticosteroid meta-analysis |
| title | Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis |
| title_full | Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis |
| title_fullStr | Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis |
| title_full_unstemmed | Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis |
| title_short | Effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis |
| title_sort | effectiveness of dupilumab treatment against refractory eosinophilic chronic rhinosinusitis |
| topic | Eosinophilic chronic rhinosinusitis dupilumab corticosteroid meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S277282932500013X |
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