Effects of Dupilumab on Eosinophilic Chronic Rhinosinusitis

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  • Usukura Norihiro
    Department of Otorhinolaryngology, Nippon Medical School Musashikosugi Hospital
  • Matsune Shoji
    Department of Otorhinolaryngology, Nippon Medical School Musashikosugi Hospital
  • Haruna Yoshihiro
    Department of Otorhinolaryngology, Nippon Medical School Musashikosugi Hospital
  • Wakayama Nozomu
    Department of Otorhinolaryngology, Nippon Medical School Musashikosugi Hospital Soshigaya E. N. T. Clinic
  • Okubo Kimihiro
    Department of Otorhinolaryngology Head and Neck Surgery, Nippon Medical School Hospital

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  • 当科における好酸球性副鼻腔炎に対するdupilumabの治療効果に関する検討

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<p>Background: Dupilumab is a fully human monoclonal antibody that blocks the common part of the interleukin(IL)-4 and -13 receptors. It has been indicated for treatment of inadequately controlled chronic rhinosinusitis with nasal polyps (CRSwNP) since March 2020 in Japan. In this study, we investigated the effects of dupilumab on eosinophilic CRS (ECRS) in CRSwNP.</p><p>Methods: A prospective observational study was performed in patients who started to use dupilumab from August to December 2020. End points included the SNOT-22 score, nasal polyp score, oral prednisolone (PSL) dose, and blood test data for total IgE, %eosinophils and levels of several cytokines.</p><p>Results: SNOT-22 scores decreased after 22/24 weeks of treatment (p < 0.01). Total IgE in blood decreased after an average of 13.3 weeks of treatment (p < 0.01), whereas %eosinophils increased significantly after the same period (p < 0.01). The required oral PSL dose was significantly lower after treatment compared with that before treatment. Vascular endothelial growth factor (VEGF) in blood decreased significantly after 15.6 weeks of treatment, but there were no significant differences in the blood levels of periostin and IL-4.</p><p>Conclusion: Patients with ECRS treated with dupilumab had rapid improvement in clinical outcomes. Total IgE and VEGF significantly decreased in the early period after treatment. While %blood eosinophils significantly increased and periostin and IL-4 in blood showed no significant changes.</p>

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