A social-economic burden of rhinosinusitis with nasal polyps with comorbid asthma and influence of dupilumab

Krysanov, I.; Krysanova, V.; Ermakova, V.

doi:10.37489/2588-0519-2021-3-16-30

GCP

2021

DOI: 10.37489/2588-0519-2021-3-16-30

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A social-economic burden of rhinosinusitis with nasal polyps with comorbid asthma and influence of dupilumab

I. Krysanov¹,

V. Krysanova

V. Ermakova³

Abstract: Rhinosinusitis with nasal polyps (RwNP) is a one of most common comorbidities in asthma and contrariwise and can lead to exacerbation of severe asthma (SA). Dupilumab is a perspective medicine for treatment of both, because it decreases exacerbations and prevents of a necessity of surgeon. Economics aspects of dupilumab treatment in RwNP + SA are not examined yet. Thus aim of this study was evaluation of social-economic burden of RwNP + SA in the Russian Federation and dupilumab influence on it. Materials and … Show more

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2023

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Cited by 2 publications

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Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Savlevich,

Lyubimova,

Zurochka

et al. 2023

Med. immunol.

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The issues of recurrencies in chronic rhinosinusitis with nasal polyps (CRSwNP) still remain unresolved. Therefore, detection patients with uncontrolled clinical course of CRSwNP is required.The aim of the present study was to assess cytokine profile in nasal polyps as well as clinical characteristics of patients with CRSwNP at varying levels of therapeutic control.The study included 99 patients with chronic rhinosinusitis. The contents of interferon IFNγ, interleukin IL- 1β, IL-4, IL-5, IL-13, tumor necrosis factor TNFα, transforming growth factors TGF-β1, TGF-β2, TGF-β3 were measured in polyp tissue samples by means of multiplex analysis. The patients were treated according to a stepwise СRSwNP therapeutic algorithm [9]. Following observation for 5 years, all patients were divided into groups, as based on medical control degree. Group 1 included patients with mild CRSwNP, who mainly received stage I and II treatment for the entire observation period. Group 2 was presented by moderate- severity CRSwNP, with stage II or III therapy according to the referred algorithm. Group 3 included the patients with severe CRSwNP who received one or more stage IV courses. The patients underwent repeated SNOT-22 questionnaire, endoscopic examination, clinical assessment. In case of bronchial asthma (BA), ACQ-7 was repeated. Initial cytokine profile of nasal polyps was analyzed by the mentioned clinical groups.Results:After 5 years of observations in group 1 (mild CRSwNP), we found a minimal decrease in quality of life (SNOT-22), severity of nasal congestion, or smell impairment. Bronchial asthma duration in these patients was significantly lower compared to group 3, the patients had better asthma control level. Cytokine profile of nasal polyps was characterized by the highest IL-4 concentration, average values IL-1β, TNFα, IFNγ and minimal TGF-β1 values.In group 2 (moderate CRSwNP), we noted more pronouced impairment of smell, nasal congestion and quality of life. Bronchial asthma was less controlled than in group 1. The maximal concentrations of IFNγ, IL-1β, TNFα, IL-5, TGF-β1, TGF-β2 were registered.In group 3 with poor CRSwNP control, the highest SNOT-22 scores, severity of difficulty in nasal breathing, impaired sense of smell were revealed. Duration of bronchial asthma was longer, with lowest levels of medical control. In nasal polyps, minimal levels of IFNγ, IL-1β, TNFα, IL-4, IL-5, TGF-β2, TGF-β3 were noted.Treatment of patients depending on the clinical phenotypes of CRSwNP in the presence/absence of allergic rhinitis or bronchial asthma may improve control and reduce incidence of relapses in CRSwNP.

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Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Savlevich,

Lyubimova,

Zurochka

et al. 2023

Med. immunol.

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Analysis of the clinical and economic effectiveness of using benralizumab in comparison with standard therapy in patients with severe bronchial asthma

Nedogoda,

Salasyuk,

Avdeev

et al. 2023

Farmakoèkonomika

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Objective: to evaluate the clinical and economic effectiveness of benralizumab in comparison with standard therapy in patients with severe bronchial asthma (SBA) with an eosinophilic phenotype in the Russian Federation.Material and methods. A clinical and economic analysis of using benralizumab in addition to standard therapy was carried out in comparison with standard therapy for SBA with an eosinophilic phenotype by means of a modeling method. Cost calculations were performed in a mathematical model adapted to the Russian healthcare conditions with the help of cost indicators and patient population characteristics.Results. The use of benralizumab as a mandatory component of standard therapy compared with standard therapy alone for SBA with an eosinophilic phenotype will allow for an additional 0.65 life years gained (LYGs) and 1.12 quality-adjusted life years (QALYs) per 1 patient during lifelong therapy. It will provide avoiding 4.95 exacerbations, simultaneously with a reduction in total costs by 584,144 rubles by reducing gross domestic product (GDP) losses due to mortality and temporary disability over an assessment horizon equal to life expectancy. The costs of 1 LYG and 1 QALY in the case of benralizumab were 869,455 and 1,252,056 rubles, in the case of standard therapy they were 911,615 and 1,303,811 rubles, respectively.Conclusion. Intensification of SBA therapy with an eosinophilic phenotype with benralizumab is clinically justified (leads to an increase in life expectancy, a decrease in the rate of exacerbations and an increase in patients’ working life), and is also economically feasible, as it allows to reduce direct costs and GDP losses of the state.

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A social-economic burden of rhinosinusitis with nasal polyps with comorbid asthma and influence of dupilumab

Cited by 2 publications

References 20 publications

Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Analysis of the clinical and economic effectiveness of using benralizumab in comparison with standard therapy in patients with severe bronchial asthma

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