ABSTRACT
BACKGROUND: This study's purposes were to evaluate the impact of biological therapies on outcomes in patients with severe asthma (SA) and chronic rhinosinusitis (CRS) and to compare these effects among those with NP (CRSwNP) versus those without NP (CRSsNP) in the "real-world" setting in Saudi Arabian patients. METHODS: From March to September 2022, a retrospective observational cohort study was undertaken at the severe asthma clinics of the Armed Forces Hospital-Southern Region (AFHSR) and King Khalid University Hospital, Abha, Saudi Arabia, to delineate the effects of dupilumab therapy. Outcomes were assessed, including clinical outcomes, FEV1, and laboratory findings before and one year after dupilumab. Post-therapy effects were compared between CRSwNP and CRSsNP. RESULTS: Fifty subjects were enrolled, with a mean age of 46.56. There were 27 (54%) females and 23(46%) males. Significant improvements in clinical parameters (frequency of asthma exacerbations and hospitalizations, the use of OCs, anosmia, SNOTT-22, and the ACT), FEV1, and laboratory ones (serum IgE and eosinophilic count) were observed 6 and 12 months after using dupilumab (p < 0.001), respectively. However, after 12 months of dupilumab therapy, there were no significant differences between those with and without NP with regards to clinical (anosmia, ACT, and OCs use), laboratory (eosinophilic count, serum IgE level) parameters, and FEV1%. CONCLUSIONS: Patients with CRS experienced significant improvements in clinical, FEV1, and laboratory outcomes after dupilumab therapy. However, these improvements were not maintained when comparing CRSwNP with CRSsNP. There were no significant differences between those with and without NP regarding ACT and OCs use or laboratory (eosinophilic count, serum IgE level) parameters. Further prospective multicenter studies are warranted.
Subject(s)
Antibodies, Monoclonal, Humanized , Asthma , Nasal Polyps , Rhinosinusitis , Adult , Female , Humans , Male , Middle Aged , Antibodies, Monoclonal, Humanized/therapeutic use , Asthma/drug therapy , Biological Therapy/methods , Chronic Disease , Immunoglobulin E/blood , Nasal Polyps/drug therapy , Nasal Polyps/complications , Retrospective Studies , Rhinosinusitis/complications , Rhinosinusitis/drug therapy , Saudi Arabia , Severity of Illness Index , Treatment OutcomeABSTRACT
OBJECTIVES: Metabolic syndrome (MetS) is a group of multiple cardiovascular risk factors, including dysglycemia, central obesity, high cholesterol, and hypertension. Cardiovascular disease is one of the most common complications of MetS. Recent studies showed that prevalence of MetS among patients admitted with acute coronary syndrome was as high as 46%. DESIGN: We conducted a cross-sectional study of 203 patients at the two main hospitals in Ta'if, Saudi Arabia. Patients older than 18 years who were admitted to the Cardiac Care Unit (CCU) between the months of August 2013 and June 2014 were asked to participate. MetS diagnosis was made based on the International Diabetes Federation definition. RESULTS: A total of 203 patients participated, with 59.1% male and 40.9% were female. The mean age was 60.9 years with a mean body mass index of 28.97 kg/m(2) and a mean waist circumference of 95.45 cm. The prevalence of MetS was 47.8%, primarily among obese female patients who reported sedentary lifestyles. Additionally, MetS patients were more likely to be admitted with heart failure (p < 0.05) and more likely to have moderate-to-severe left-ventricular hypertrophy (LVH; p < 0.05) relative to non-MetS patients. CONCLUSION: Of the patients admitted to the CCU, 47.8% had MetS, with those patients likely to be female and obese. Furthermore, MetS patients were more likely to be admitted with heart failure and suffer from moderate-to-severe LVH.