1. Effectiveness and safety of dupilumab in patients with chronic rhinosinusitis with nasal polyps and associated comorbidities: a multicentric prospective study in real life
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Eustachio Nettis, Luisa Brussino, Vincenzo Patella, Laura Bonzano, Aikaterini Detoraki, Elisabetta Di Leo, Maria Maddalena Sirufo, Cristiano Caruso, Fabio Lodi Rizzini, Mariaelisabetta Conte, Mona-Rita Yacoub, Massimo Triggiani, Erminia Ridolo, Luigi Macchia, Giovanni Rolla, Raffaele Brancaccio, Amato De Paulis, Giuseppe Spadaro, Danilo Di Bona, Angela Maria D’Uggento, Lia Ginaldi, Francesco Gaeta, Eleonora Nucera, Kliljeda Jaubashi, Danilo Villalta, Lorenzo Dagna, Domenico Ciotta, Francesco Pucciarini, Diego Bagnasco, Giorgio Celi, Fulvia Chieco Bianchi, Lorenzo Cosmi, Maria Teresa Costantino, Maria Angiola Crivellaro, Simona D’Alò, Pietro del Biondo, Stefano Del Giacco, Mario Di Gioacchino, Linda Di Pietro, Elisabetta Favero, Sebastiano Gangemi, Gabriella Guarnieri, Enrico Heffler, Maria Stefania Leto Barone, Carla Lombardo, Francesca Losa, Andrea Matucci, Paola Lucia Minciullo, Paola Parronchi, Giovanni Passalacqua, Stefano Pucci, Oliviero Rossi, Lorenzo Salvati, Michele Schiappoli, Gianenrico Senna, Andrea Vianello, Alessandra Vultaggio, Yang Baoran, Cristoforo Incorvaia, and Giorgio Walter Canonica
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Background Biologics are currently one of the main treatment options for a number of diseases. The IgG4 monoclonal antibody dupilumab targets the Interleukin-4 receptor alpha chain, thus preventing the biological effects of the cytokines IL-4 and IL-13, that are essential for the Th2 response. Several controlled trials showed that dupilumab is effective and safe in patients with atopic dermatitis (AD), severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), thus resulting in approval by regulatory agencies. Aim of the study was to evaluate the efficacy and safety of dupilumab in adult patients with CRSwNP stratified by common overlapping comorbid conditions. Methods We performed a multicenter, observational, prospective study enrolling adult patients with severe CRSwNP who had started dupilumab treatment in the context of standard care from January 2021 to October 2021. Data were collected from twentynine Italian secondary care centers for allergy and clinical immunology, all of which were part of the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC). A number of efficacy parameters were used. Patient data were compared using the Wilcoxon test for paired data. All statistical analyses were performed with SPSS version 20 (IBM, Armonk, NY, USA). Results In total, 82 patients with nasal polyposis were identified. A significant improvement was detected for all the applied efficacy parameters, i.e. 22-item Sino-Nasal Outcome Test (SNOT-22) and bilateral endoscopic nasal polyp score (NPS) scores for CRSwNP, Rhinitis Control Scoring System (RCSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores for allergic perennial rhinitis, Forced Expiratory Volume in the 1st second (FEV1) and Asthma Quality of Life Questionnaire (AQLQ) scores for asthma, Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) scores for AD. A non-significant improvement was also obtained in the Urticaria Activity Score over 7 days (UAS7) for chronic spontaneous urticaria. Treatment with dupilumab was well tolerated. Conclusions These data suggest that dupilumab treatment in patients suffering from CRSwNP and associated comorbidities may be suitable. Such outcome, although confirmation by trials is warranted, suggests the possibility to treat different disorders with a single therapy, with favorable effects especially under the cost-effectiveness aspect.
- Published
- 2022
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