Effectiveness of Dupilumab in the Treatment of Adult and Older Adult Patients with Severe, Uncontrolled CRSwNP
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Published:2023-08-10
Issue:8
Volume:13
Page:1241
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ISSN:2075-4426
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Container-title:Journal of Personalized Medicine
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language:en
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Short-container-title:JPM
Author:
Ottaviano Giancarlo1ORCID, De Corso Eugenio2ORCID, Saccardo Tommaso1ORCID, D’Auria Leandro Maria2ORCID, Zampollo Sonny1, D’Agostino Giuseppe2ORCID, Mairani Edoardo1, De Maio Gabriele2, Scarpa Bruno3ORCID, Bacci Christian4ORCID, Favero Vittorio5ORCID
Affiliation:
1. Department of Neurosciences DNS, Otolaryngology Section, University of Padova, 35122 Padova, Italy 2. Department of Otolaryngology, Policlinico Gemelli University Hospital IRCCS, 00168 Rome, Italy 3. Department of Statistical Sciences, University of Padova, 35122 Padova, Italy 4. Unit of Dentistry, Department of Neurosciences, University of Padua, 35122 Padova, Italy 5. Unit of Maxillofacial Surgery and Dentistry, Head and Neck Department, University of Verona, 37134 Verona, Italy
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease that significantly impacts patients’ quality of life. New therapeutic strategies and in particular biologic treatments are now available for these patients. It has been demonstrated that Dupilumab (an anti IL-4/IL-13 biologic drug) is effective in reducing the size of nasal polyps and in improving patients’ symptoms and thus, quality of life. No real-world studies examining Dupilamab’s efficacy in the elderly with respect to other adult age groups have as yet been carried out. The aim of this multicentric study was to evaluate Dupilumab’s efficacy in young–middle adults as opposed to an older adult population affected by severe, uncontrolled CRSwNP. Of the 96 patients included in the study, 22 were 65 years old or older. Significant improvements were observed in all the parameters considered in both age groups after treatment was begun (T0 mean values for SNOT-22 = 58.5 ± 20.3, VAS NO = 7.6 ± 2.2, VAS smell = 8.6 ± 2.1, NPS = 5.6 ± 1.4, PNIF = 101.6 ± 59.4, S’S = 5.1 ± 3.1), T4 mean values for SNOT-22 = 15.1 ± 12.7, VAS NO = 1.7 ± 1.8, VAS smell = 2.4 ± 3, NPS = 1.7 ± 1.7, PNIF = 162.4 ± 43.2, S’S = 10.4 ± 3.7) (p < 0.0001). No differences in the variables considered were observed between the two age groups during the study, with the exception of the Peak Nasal Inspiratory Flow (PNIF), which was marginally higher; this was also the case according to multivariate analyses (p = 0.008) in the young–middle adult group with respect to the elderly one (p = 0.07). At multivariate analyses, asthma and the female sex negatively influenced the PNIF values (p = 0.001 and p = 0.012, respectively). Age negatively influenced the Visual Analog Scale (VAS) for nasal obstruction (p = 0.0032) and Endoscopic Sinus Surgery (ESS) negatively influenced the patents’ olfactory performance (p = 0.028) to the same degree in both groups. Dupilumab was found to be effective to the same degree in both age groups. It can be considered a safe and reliable option for the treatment of elderly patients with severe, uncontrolled CRSwNP.
Subject
Medicine (miscellaneous)
Reference37 articles.
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