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RESEARCH PRODUCT
Effects of Omalizumab Treatment in Patients With Recalcitrant Nasal Polyposis and Mild Asthma: A Multicenter Retrospective Study
Noelia Muñoz-fernándezMiguel Armengot-carcellerMarta Palop-cerveraCarmen García-navalónAinhoa García-lliberós De MiguelAlfonso García PiñeroJaime Marco-algarraMaría José Gómez-gómezEncarna Doménech-campossubject
Adultmedicine.medical_specialtyMild asthmaOmalizumabOmalizumabaspirin-exacerbated respiratory diseasechronic rhinosinusitis with nasal polypsImmunoglobulin E03 medical and health sciencesNasal Polyps0302 clinical medicineQuality of lifeSNOT-22Internal medicinemedicineHumansImmunology and AllergyNasal polypsIn patient030223 otorhinolaryngologyRetrospective StudiesRhinitisnasal polypsbiologybusiness.industrytotal nasal endoscopic polyp scoreRetrospective cohort studyGeneral Medicinemedicine.diseaseAsthmaTreatment Outcomequality of lifetissue eosinophilia030228 respiratory systemOtorhinolaryngologyIgE SNOT-22 aspirin-exacerbated respiratory disease chronic rhinosinusitis with nasal polyps mild asthma nasal polyps omalizumab quality of life tissue eosinophilia total nasal endoscopic polyp scoreChronic DiseaseQuality of Lifebiology.proteinomalizumabAspirin exacerbated respiratory diseaseIgEbusinessmild asthmamedicine.drugdescription
Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is a clinical entity with specific features that impacts significantly on patient quality of life (QoL). CRSwNP is often associated with asthma and is difficult to control and manage despite pharmacological and/or surgical treatment. Omalizumab, a monoclonal anti-IgE antibody, has emerged as a putative therapeutic option. Objective To evaluate the effects of omalizumab on nasal polyp (NP) size and QoL assessed by Sino-Nasal Outcome Test-22 (SNOT-22) in patients with recalcitrant CRSwNP and mild asthma. Methods A multicenter retrospective analysis of patient data from the Community of Valencia (Spain) was performed. Adult patients with recalcitrant CRSwNP and comorbid mild asthma receiving compassionate use of omalizumab were included. NP size measured by total nasal endoscopic polyp score (TPS) and QoL evaluated through the SNOT-22 questionnaire were assessed at baseline and monthly over 12 months. An ordinal regression model was built to analyze the results. Results A total of 23 CRSwNP patients with a mean age (± SD) of 54.78 ± 9.46 years were included. Nineteen suffered from aspirin-exacerbated respiratory disease (AERD). In all patients, a significant and sustained reduction in TPS was observed over time, accompanied by improvements in QoL reflected in lower SNOT-22 scores. In the ordinal regression model, time but not total IgE, age or tissue eosinophilia impacted on NP size and SNOT-22 outcomes. Additionally, improvements in QoL were not explained by reductions in the size of polyps. Conclusion Omalizumab was effective for the treatment of patients with recalcitrant CRSwNP and mild asthma, even when AERD was present, by reducing NP size and improving QoL; treatment time was a key factor. SNOT-22 improvements were not explained by decreases in TPS, indicating that omalizumab may be effective in all patients, regardless of polyp size.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-01-01 | American Journal of Rhinology & Allergy |