Dupilumab improves health‐related quality of life in patients with chronic rhinosinusitis with nasal polyposis

Abstract

Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) negatively affects health-related quality of life (HRQoL). In a previously reported randomized clinical trial (NCT01920893), addition of dupilumab to mometasone furoate in patients with CRSwNP refractory to intranasal corticosteroids (INCS) significantly improved endoscopic, radiographic, and clinical endpoints and patient-reported outcomes. The objective of this analysis was to examine the impact of dupilumab treatment on HRQoL and productivity using secondary outcome data from this trial. Methods: Following a 4-week mometasone furoate nasal spray run-in, patients were randomized to commence subcutaneous dupilumab (600 mg loading dose, then 300 mg once weekly for 15 weeks [n = 30], or matched placebo [n = 30]). Outcomes included scores on the CRS disease severity visual analog scale (VAS), 22-item Sino-Nasal Outcome Test (SNOT-22), 5-dimension EuroQoL (EQ-5D) general health status VAS, and 36-item Short-Form Health Survey (SF-36) for HRQoL and nasal polyp-related healthcare resource use questionnaires. Results: Following 16 weeks of treatment, the proportion of patients with moderate-to-severe CRSwNP (VAS > 3-10) decreased from 86.2% to 21.4% with dupilumab and 88.0% to 84.2% with placebo. Dupilumab (vs placebo) resulted in significantly greater improvement in HRQoL, based on SNOT-22, SF-36, and EQ-5D VAS scores. The dupilumab group had a significantly lower adjusted annualized mean number of sick leave days (0.09, vs 4.18 with placebo, P = .015) and significantly greater improvement (vs placebo) in the SNOT-22 item "reduced productivity." Conclusions: In adults with CRSwNP refractory to treatment with INCS alone, the addition of dupilumab reduced disease severity, significantly improved HRQoL, and improved productivity.

Dupilumab for the Treatment of Atopic Dermatitis in an Austrian Cohort-Real-Life Data Shows Rosacea-Like Folliculitis

“…We also noticed a Dupilumab-dependent decrease of IgE levels later during the study, consistent with previous reports, and in line with the concept that IL-4 and IL-13 play a pivotal role in IgE synthesis by B-cells [25,26]. Whether this effect of Dupilumab will eventually lead to a reduction in clinical symptoms of seasonal and nutritive allergies has yet to be determined [27,28].…”

Biologics for chronic rhinosinusitis with nasal polyps

“…Dupilumab resulted in significantly greater improvements in health-related QOL compared with placebo, based on SNOT-22, 36-item short form survey, EQ-5D, and VAS scores, and significantly lower adjusted annualized mean number of sick leave days as well as a significantly greater improvement in reduced productivity. 102 In patients with CRSwNP with comorbid asthma, a significant difference versus placebo was also observed for each of the individual ACQ-5 item scores. 103 The changes in CT scan sinus opacification were seen in all sinuses.…”

<p>Therapeutic Potential of Dupilumab in the Treatment of Chronic Rhinosinusitis with Nasal Polyps: Evidence to Date</p>

“…In a follow up analysis of the same study cohort, the effect of dupilumab add-on treatment on clinical outcomes was analyzed. 13…”