[Chronic rhinosinusitis with nasal polyps-extension of dupilumab treatment intervals]. / Chronische Rhinosinusitis mit nasalen Polypen Verlängerung der Dupilumab-Therapieintervalle.
HNO
; 72(7): 499-503, 2024 Jul.
Article
em De
| MEDLINE
| ID: mdl-38761229
ABSTRACT
BACKGROUND:
In patients with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP), dupilumab 300â¯mg every 2 weeks can completely resolve nasal polys, sinus disease, and symptoms. In this case, patients ask for de-escalation. Although trials have demonstrated recurrence after stopping the biologic at 24 weeks, reducing the dose of dupilumab to once every 4 weeks did not result in deterioration of control. An extension of the treatment intervals would, however, diverge from the approval text, and is currently not recommended.METHODS:
The course of 29 patients with severe CRSwNP, type2 inflammation-associated comorbidities, and an indication for biologic was retrospectively analyzed. After resolution of CRSwNP and symptoms under biweekly dupilumab 300â¯mg, the dupilumab interval had been prolonged individually, initially up to 4 weeks, thereafter up to 6 weeks, if applicable. Control was assessed via quality of life (22-item sinonasal outcome test, SNOT-22), nasal polyp score, and smell identification test (Sniffin' Sticks; Burghart Messtechnik, Holm, Germany).RESULTS:
All patients showed an excellent improvement within the first 3 months. The dupilumab application interval was extended to 4 weeks after 7-31 months (median 13 months) and to 6 weeks (nâ¯= 9) after 17-35 months (median 23 months). No recurrent polyps or symptoms were subsequently observed.CONCLUSION:
In case of maximal regression of polyps and discomfort, extension of dupilumab injection intervals to 4 and potentially 6 weeks is possible without clinical worsening. Further studies on de-escalation or termination of biologic treatment when CRSwNP control is achieved are essential.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sinusite
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Rinite
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Pólipos Nasais
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Anticorpos Monoclonais Humanizados
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
De
Revista:
HNO
Ano de publicação:
2024
Tipo de documento:
Article