Effect of Treatment with Dupilumab for Eosinophilic Chronic Rhinosinusitis

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  • Matsuyama Toshiyuki
    Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine
  • Takahashi Hideyuki
    Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine
  • Tada Hiroe
    Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine
  • Nagata Yurino
    Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine
  • Chikamatsu Kazuaki
    Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine

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Other Title
  • 好酸球性副鼻腔炎に対する dupilumab の臨床効果
  • コウサンキュウセイ フクビクウエン ニ タイスル dupilumab ノ リンショウ コウカ

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Abstract

<p>　Biologic medications are expected as a new treatment for eosinophilic chronic rhinosinusitis (ECRS). In this study, we investigated the treatment effect of anti-IL-4/13 receptor antibody (dupilumab) for ECRS. Twelve patients with ECRS treated with dupilumab were enrolled, and the clinical factors, including the nasal polyp score, Lund-Mackay score on computed tomography (CT), percentage of eosinophils in the peripheral blood, and oral prednisolone (PSL) doses were compared between before treatment initiation and after 8 weeks of dupilumab treatment. The nasal polyp score and CT score after treatment were significantly lower than those before treatment (nasal polyp score: p<0.01; CT score: p<0.01). The oral PSL dose after treatment was significantly decreased as compared with that before treatment (p=0.02). On the contrary, the percentage of eosinophils in the peripheral blood increased significantly after treatment (p=0.04). Meanwhile, there was no correlation between the percentage of eosinophils in the peripheral blood and the change in the CT score or nasal polyp score after treatment. Dupilumab improved the clinical outcomes of ECRS within a short period of time and allowed the dose of oral PSL to be reduced, or for PSL to be altogether discontinued. Therefore, it is considered that dupilumab may be a valid treatment alternative for ECRS. In addition, despite the increase in the count of eosinophils in the blood, the clinical outcomes of ECRS improved after dupilumab treatment, suggesting that blood eosinophils may be a biomarker for the diagnosis of nasal sinus type 2 inflammation, but not a satisfactory indicator of the treatment effect.</p>

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 124 (6), 884-889, 2021-06-20

    Japanese Society of Otorhinolaryngology-Head and neck surgery

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