ORIGINAL ARTICLE   

Otorhinolaryngology 2023 March;73(1):1-7

DOI: 10.23736/S2724-6302.22.02454-9

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Biologics in the management of chronic rhinosinusitis with nasal polyposis: a real-life experience

Stefano MILLARELLI ¹, Antonella LOPERFIDO ¹ ✉, Cristina GIORGIONE ¹, Alessandra CELEBRINI ¹, Massimiliano DEL NINNO ¹, Loreta DI MICHELE ², Gianluca BELLOCCHI ¹

¹ Department of Otolaryngology, San Camillo Forlanini Hospital, Rome, Italy; ² Department of Pulmonary Interstitial Diseases, San Camillo Forlanini Hospital, Rome, Italy

BACKGROUND: The introduction of biologics in the management of chronic rhinosinusitis with nasal polyposis (CRSwNP) has allowed new therapeutic options and Dupilumab represents the first approved biological agent. Aim of this article is to report our preliminary experience in the evaluation of quality-of-life outcomes in CRSwNP patients treated with biologics.
METHODS: Our center of Rhino-Allergology and the Pneumology Unit have been cooperating in a multidisciplinary management to treat patients with CRSwNP and/or with concomitant asthma. We have enrolled 37 patients with CRSwNP treated with Dupilumab. We have developed a dedicated collection form to monitor patients’ compliance to therapy and their clinical outcomes. This collection form consisted of three parts: an anamnestic collection data, a clinician reported outcome and two PROMs questionnaire namely a Visual Analogue Scale (VAS) and the Sino-Nasal Outcome Test-22 (SNOT-22).
RESULTS: We describe clinical outcomes of patients enrolled since December 2020 from our center of RhinoAllergology affected by CRSwNP treated with Dupilumab. 60% of patients were male and 40% were female, the mean age was 58,7 years. Monitoring our patients, we have noticed a considerable respiratory gain associated with a nasal symptoms improvement. In particular, we found a significant improvement of nasal congestion, loss of smell, post-nasal drip, nasal polyp score, SNOT-22 and VAS.
CONCLUSIONS: The role of Dupilumab in the management of CRSwNP is emerging. Based on our preliminary observations, quality of life has shown an improvement, especially in the loss of smell. Further studies are needed to develop tailored guidelines and to identify the correct clinical indications to biologics therapy in CRSwNP patients.

KEY WORDS: Sinusitis; Nasal polyps; Quality of life; Biologics