Chronic Rhinosinusitis with Polyps and Comorbid Asthma: Results of Reslizumab Treatment

Abstract

BACKGROUND:  Chronic  rhinosinusitis  with  nasal  polyps  (CRSwNP)  and  asthma  are  comorbid,  mutually burdening, difficult-to-treat diseases. The presence of a correlation between the severity of the course of CRSwNP and eosinophilic asthma, the  proximity of the endotypes of these diseases, and the success in the application of humanized monoclonal antibodies for the treatment of severe asthma explain the interest in the study of the possibility of using this group of medications in patients with CRSwNP. AIM: The present study purposes to evaluate changes in the severity of CRS symptoms in patients with comorbid asthma during reslizumab treatment. The clinical effect of the treatment, the dynamics of subjective and objective characteristics of (CRSwNP) and asthma symptoms, indicators of general and local eosinophilia have been analyzed. MATERIALS AND METHODS: The study involved 18 patients with severe eosinophilic asthma, treated with reslizumab. Research protocol: the first examination conducted before reslizumab treatment included an assessment of clinical symptoms using Sino-nasal outcome test-22 and asthma control test, endoscopic examination of the nasal cavity, computed tomography of the paranasal sinuses, rhinocytogram, determination of the content of eosinophils and eosinophil cation protein in the blood, spirometry. Evaluation of the results of treatment was carried out after 6 injections of reslizumab at a dose of 3 mg/kg 1 time every 4 weeks. The obtained data were processed by means of the “Statistica 12.0” program (StatSoft, USA). The  differences in the indicators were considered statistically significant at p < 0.05. RESULTS: After 6 injections of reslizumab both a noticeable improvement in asthma control and a decrease in the severity of the nasal symptoms were noted. A more evident effect in diminution of asthma symptoms due to the use of reslizumab was obtained in patients with severe eosinophilic asthma with CRSwNP compared with cases without polyps. CONCLUSION: Treatment with reslizumab in patients with eosinophilic asthma and concomitant CRS with polyps and eosinophilic CRS leads not only to improved control of asthma symptoms but also to significant regression of nasal symptoms.