デュピルマブ導入後にトラフェルミン製剤を用いて鼓膜再生療法を施行した好酸球性中耳炎例

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  • A Case of Eosinophilic Otitis Media Treated by Dupilumab and Regenerative Medicine with Trafermin
  • デュピルマブ ドウニュウ ゴ ニ トラフェルミン セイザイ オ モチイテ コマク サイセイ リョウホウ オ シコウ シタ コウサンキュウセイ チュウジエンレイ

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<p>Eosinophilic otitis media (EOM), which is characterized by effusion caused by the accumulation of eosinophils in the middle ear mucosa, is a type of refractory otitis media that is often associated with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Despite the critical need for management of the eosinophilic inflammation of the middle ear and of the comorbid airway diseases using topical and systemic steroids, no well-established treatments exist currently. Dupilumab, an anti-interleukin (IL)-4R alpha monoclonal antibody, has been approved for the treatment of atopic dermatitis, severe asthma, and refractory CRSwNP. This report presents the case of patient with EOM complicated by severe asthma and eosinophilic chronic rhinosinusitis (ECRS), in whom the EOM symptoms improved after dupilumab administration. After the resolution of EOM was clinically confirmed, regenerative treatment was administered using a trafermin kit (Retympa®) for the tympanic membrane perforation caused by the EOM. At the 6-month follow-up, the patient’s hearing level had improved and the tympanic membrane had healed successfully. Thus, optimized therapy for eosinophilic inflammatory diseases including type 2 inflammatory agents, such as IL-4 and -13, may be important to manage the clinical condition of EOM associated with asthma and ECRS.</p>

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