Biologics for chronic rhinosinusitis

Chong, Lee Yee; Piromchai, Patorn; Sharp, Steve; Snidvongs, Kornkiat; Webster, Katie E; Philpott, Carl; Hopkins, Claire; Burton, Martin J

doi:10.1002/14651858.cd013513.pub3

Cited by 50 publications

(46 citation statements)

References 122 publications

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“…Compared with previous SRs, the current study shows a similar effect of dupilumab regarding the improvement in quality of life and nasal polyp score, and similar limited evidence regarding mepolizumab and reslizumab. 57,58 Meanwhile, the inclusion of the two newly completed Gevaert 2006 reported the median of change from baseline (reslizumab 1 mg/kg = −1.0; placebo = 0; reslizumab 3 mg/kg = 0.5; placebo = 0), "significant" and "nonsignificant," respectively Note: The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).…”

Section: Results In the Context Of Previous Researchmentioning

confidence: 99%

Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps: A systematic review for the EAACI guidelines

Agache

Song

Alonso‐Coello

et al. 2021

Allergy

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This systematic review evaluates the efficacy and safety of biologicals for chronic rhinosinusitis with nasal polyps (CRSwNP) compared with the standard of care.PubMed, Embase, and Cochrane Library were searched for RCTs. Critical and important CRSwNP-related outcomes were considered. The risk of bias and the certainty of the evidence were assessed using GRADE. RCTs evaluated (dupilumab-2, omalizumab-4, mepolizumab-2, and reslizumab-1) included 1236 adults, with follow-up of 20-64 weeks. Dupilumab reduces the need for surgery (NFS) or oral corticosteroid (OCS) use (RR 0.28; 95% CI 0.20-0.39, moderate certainty) and improves with high certainty smell evaluated with UPSIT score (mean difference (MD) +10.54; 95% CI +9.24 to +11.84) and quality of life (QoL) evaluated with ; 95% CI −22.80 to −15.47), with fewer treatment-related adverse events (TAEs) (RR 0.95; 95% CI 0.89-1.02, moderate certainty). Omalizumab reduces NFS (RR 0.85; 95% CI 0.78-0.92, high certainty), decreases OCS use (RR 0.38; 95% CI 0.10-1.38, moderate certainty), and improves high certainty smell (MD +3.84; 95% CI +3.64 to +4.04) and QoL (MD −15.65; 95% CI −16.16 to −15.13), with increased TAE (RR 1.73; 95% CI 0.60-5.03, moderate certainty). There is low certainty for mepolizumab reducing NFS

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Section: Results In the Context Of Previous Researchmentioning

confidence: 99%

Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps: A systematic review for the EAACI guidelines

Agache

Song

Alonso‐Coello

et al. 2021

Allergy

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“…In a recent Cochrane review evaluating nasal irrigation for allergic rhinitis, the researchers performed a subgroup analysis for the type of irrigation device. However, there was heterogeneity among the studies that were reviewed, and the results were inconclusive [3,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Nasal saline irrigation is a common procedure to relieve nasal symptoms in upper respiratory tract infection such as nasopharyngitis (common cold) and rhinosinusitis [1][2][3]. The physician usually prescribes normal saline along with the appropriate medications (e.g., antihistamines, nasal steroids, or antibiotics) to treat these conditions [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

Syringe with Nasal Applicator versus Syringe Alone for Nasal Irrigation in Acute Rhinosinusitis: A Matched-Pair Randomized Controlled Trial

Piromchai¹,

Phannikul²,

Thanaviratananich³

2021

Biomed Hub

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Background/Aims: Nasal saline irrigation is a common procedure to relieve nasal symptoms in upper respiratory tract diseases. There is no consensus on the recommended nasal saline delivery devices. The objectives of this study were to evaluate efficacy, satisfaction, adherence, and adverse effects in patients with acute upper respiratory tract diseases using a syringe with a nasal applicator for nasal irrigation. Methods: Patients with acute nasopharyngitis, acute rhinitis, or acute rhinosinusitis were randomly allocated to use either (1) a syringe with a nasal applicator or (2) a syringe alone to irrigate one nostril. After the patients had completed irrigation with the allocated device in one nostril, they were instructed to perform nasal irrigation using the other device in the other nostril. All patients were instructed to use a syringe with a nasal applicator at home. The efficacy, satisfaction scores, adherence, and adverse effects were recorded. Results: Sixty-four patients were enrolled. The mean age of the patients was 33.95 years (18–59 years). The mean duration of symptoms was 4.80 days. None of the enrolled patients regularly performed nasal irrigation. Forty-two had acute nasopharyngitis, 10 had acute rhinitis, and 12 had acute rhinosinusitis. At baseline, the mean overall efficacy score for the syringe with a nasal applicator was 8.17 ± 1.43, and that for the syringe alone was 5.95 ± 2.02 (MD 2.23, p < 0.001, 95% CI 1.75–2.70). At 1 week, the syringe with the nasal applicator had significantly higher scores in 3 of 4 domains, including symptom relief, ease of use, and patients’ willingness to recommend the device to others, compared to baseline (p < 0.05). None of the enrolled patients had epistaxis, retained/dislodged the applicator during irrigation, or experienced an allergic reaction to the applicator after 1 week of nasal irrigation. Conclusion: Use of a syringe with an applicator for nasal irrigation yielded high scores in overall efficacy.

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“…The data show disease‐specific quality of life, measured on a scale of 0 to 110, where a lower score means better quality of life, for 3 clinical trials of dupilumab versus placebo in adults with chronic rhinosinusitis and nasal polyps, who were all concomitantly treated with topical steroids (mometasone furoate 100 mcg each nostril twice daily) through the study. Chong, et al, 11 permission to reproduce granted…”

Section: Figurementioning

confidence: 99%

“…The data show disease-specific quality of life, measured on a scale of 0 to 110, where a lower score means better quality of life, for 3 clinical trials of dupilumab versus placebo in adults with chronic rhinosinusitis and nasal polyps, who were all concomitantly treated with topical steroids (mometasone furoate 100 mcg each nostril twice daily) through the study. Chong, et al, 11 permission to reproduce granted EDITORIAL clinical trial publications to publish their protocol in the supplement or another public repository. It is surprising that many high-profile journals still publish clinical trials without any public record of the trial protocol.…”

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confidence: 99%

Evidence Synthesis in Allergy – A call for submissions

Boyle

Shamji

2021

Clin Experimental Allergy

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This month, we launch a call for studies related to evidence synthesis in allergy. The importance of synthesizing previous and emerging evidence in parallel with making new scientific discoveries has been championed since the late 19th century. However, it was only in the 1970s that the idea of using meta-analysis to achieve this aim started We very much look forward to receiving manuscript submissions in response to our call for evidence synthesis in allergy articles and to sharing the papers in this special collection through our journal in the coming months.

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Biologics for chronic rhinosinusitis

Abstract: Biologics for chronic rhinosinusitis.

Cited by 50 publications

References 122 publications

Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps: A systematic review for the EAACI guidelines

Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps: A systematic review for the EAACI guidelines

Syringe with Nasal Applicator versus Syringe Alone for Nasal Irrigation in Acute Rhinosinusitis: A Matched-Pair Randomized Controlled Trial

Evidence Synthesis in Allergy – A call for submissions

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