Therapeutic Effectiveness of SNOT 22-Based Interdose Interval Adjustment of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives. This study evaluates the enduring efficacy and patient satisfaction of dupilumab with interdose interval adjustments based on the Sino-Nasal Outcome Test (SNOT-22) in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods. A retrospective analysis was conducted on 44 patients who had been treated with dupilumab for over 6 months. This study targeted individuals diagnosed with CRSwNP according to the 2020 edition of the European Position Paper on Rhinosinusitis and Nasal Polyps Criteria. The treatment involved an add-on dupilumab regimen, where the interdose interval was adjusted based on the SNOT-22 scores. Dosage adjustments were made such that patients with initial SNOT-22 scores greater than 40 were tapered to a target level of 20 or less. Similarly, for patients with initial scores of 40 or less, the treatment aimed for an improvement of 50% or more. At each visit, the effectiveness of the treatment was evaluated using SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire adapted from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4). Results. The adjustment of the interdose interval for dupilumab based on SNOT-22 scores demonstrated sustained improvements in patients’ subjective symptoms, satisfaction, and NPS. The mean (standard deviation) SNOT-22 scores significantly decreased from 46.04 (22.30) to 14.72 (13.66) over 6 months (P<0.001). Similarly, NPS scores improved from 3.20 (2.24) to 1.72 (1.46) within the same period (P<0.001). Satisfaction scores, ranging from 0 to 5, consistently remained above 3.5 for up to 6 months (P=0.166). Additionally, there was a significant correlation between the improvement in the nasal symptom domain of the SNOT-22 scores and higher satisfaction scores. Conclusion. Adjusting dupilumab dosing intervals based on SNOT-22 scores from the outset resulted in sustained efficacy and patient satisfaction in Korean patients with CRSwNP. This approach will meaningfully assist clinicians in determining the optimal dupilumab dosing interval.
Abstract
Objectives. This study evaluates the enduring efficacy and patient satisfaction of dupilumab with interdose interval adjustments based on the Sino-Nasal Outcome Test (SNOT-22) in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods. A retrospective analysis was conducted on 44 patients who had been treated with dupilumab for over 6 months. This study targeted individuals diagnosed with CRSwNP according to the 2020 edition of the European Position Paper on Rhinosinusitis and Nasal Polyps Criteria. The treatment involved an add-on dupilumab regimen, where the interdose interval was adjusted based on the SNOT-22 scores. Dosage adjustments were made such that patients with initial SNOT-22 scores greater than 40 were tapered to a target level of 20 or less. Similarly, for patients with initial scores of 40 or less, the treatment aimed for an improvement of 50% or more. At each visit, the effectiveness of the treatment was evaluated using SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire adapted from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4). Results. The adjustment of the interdose interval for dupilumab based on SNOT-22 scores demonstrated sustained improvements in patients’ subjective symptoms, satisfaction, and NPS. The mean (standard deviation) SNOT-22 scores significantly decreased from 46.04 (22.30) to 14.72 (13.66) over 6 months (P<0.001). Similarly, NPS scores improved from 3.20 (2.24) to 1.72 (1.46) within the same period (P<0.001). Satisfaction scores, ranging from 0 to 5, consistently remained above 3.5 for up to 6 months (P=0.166). Additionally, there was a significant correlation between the improvement in the nasal symptom domain of the SNOT-22 scores and higher satisfaction scores. Conclusion. Adjusting dupilumab dosing intervals based on SNOT-22 scores from the outset resulted in sustained efficacy and patient satisfaction in Korean patients with CRSwNP. This approach will meaningfully assist clinicians in determining the optimal dupilumab dosing interval.
참고문헌 (42)
- Hastan D, "Chronic rhinosinusitis in Europe : an underestimated disease. A GA²LEN study", Allergy, 66(9), pp.1216~1223 (2011)
- Shi JB, "Epidemiology of chronic rhinosinusitis : results from a cross-sectional survey in seven Chinese cities", Allergy, 70(5), pp.533~539 (2015)
- Kim JH, "Prevalence and risk factors of chronic rhinosinusitis in South Korea according to diagnostic criteria", Rhinology, 54(4), pp.329~335 (2016)
- Xu Y, "Prevalence and incidence of diagnosed chronic rhinosinusitis in Alberta, Canada", JAMA Otolaryngol Head Neck Surg, 142(11), pp.1063~1069 (2016)
- Dietz de Loos D, "Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology", J Allergy Clin Immunol, 143(3), pp.1207~1214 (2019)
- Fokkens WJ, "European Position Paper on rhinosinusitis and nasal polyps 2020", Rhinology, 58(Suppl S29), pp.1~464 (2020)
- Lourijsen ES, "Endoscopic sinus surgery with medical therapy versus medical therapy for chronic rhinosinusitis with nasal polyps : a multicentre, randomised, controlled trial", Lancet Respir Med, 10(4), pp.337~346 (2022)
- Hopkins C, "Does time to endoscopic sinus surgery impact outcomes in chronic rhinosinusitis? : prospective findings from the National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis", Rhinology, 53(1), pp.10~17 (2015)
- Arancibia C, "Twelve-year long-term postoperative outcomes in patients with chronic rhinosinusitis with nasal polyps", Rhinology, 60(4), pp.261~269 (2022)
- Hox V, "Benefits and harm of systemic steroids for short-and long-term use in rhinitis and rhinosinusitis : an EAACI position paper", Clin Transl Allergy, 10, pp.1~ (2020)
- Eriksen PR, "The potential role of biological treatment of chronic rhinosinusitis with nasal polyps : a nationwide cohort study", Rhinology, 59(4), pp.374~379 (2021)
- Xu X, "Updates in biologic therapy for chronic rhinosinusitis with nasal polyps and NSAID-exacerbated respiratory disease", Allergy, 77(12), pp.3593~3605 (2022)
- Staudacher AG, "Use of endotypes, phenotypes, and inflammatory markers to guide treatment decisions in chronic rhinosinusitis", Ann Allergy Asthma Immunol, 124(4), pp.318~325 (2020)
- Bachert C, "Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps(LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52) : results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials", Lancet, 394(10209), pp.1638~1650 (2019)
- Lee Y, "Real clinical practice data of monthly dupilumab therapy in adult patients with moderate-to-severe atopic dermatitis : clinical efficacy and predictive markers for a favorable clinical response", Allergy Asthma Immunol Res, 13(5), pp.733~745 (2021)
- Parasher AK, "Economic evaluation of dupilumab versus endoscopic sinus surgery for the treatment of chronic rhinosinusitis with nasal polyps", Int Forum Allergy Rhinol, 12(6), pp.813~820 (2022)
- Yao Y, "Revisiting Asian chronic rhinosinusitis in the era of type 2 biologics", Clin Exp Allergy, 52(2), pp.231~243 (2022)
- Kim DW, "Application of biologics in treating chronic rhinosinusitis with nasal polyps in Asian populations", Clin Exp Otorhinolaryngol, 15(2), pp.125~126 (2022)
- Min JY, "Inflammatory endotypes of chronic rhinosinusitis in the Korean population : distinct expression of type 3 inflammation", Allergy Asthma Immunol Res, 15(4), pp.437~450 (2023)
- van der Lans RJ, "Two-year results of tapered dupilumab for CRSwNP demonstrates enduring efficacy established in the first 6 months", Allergy, 78(10), pp.2684~2697 (2023)
- Toma S, "Stratification of SNOT-22 scores into mild, moderate or severe and relationship with other subjective instruments", Rhinology, 54(2), pp.129~133 (2016)
- Phillips KM, "Patient-reported chronic rhinosinusitis disease control is a valid measure of disease burden", Rhinology, 59(6), pp.545~551 (2021)
- Ueki S, "Eosinophil ETosis and DNA traps : a new look at eosinophilic inflammation", Curr Allergy Asthma Rep, 16(8), pp.54~ (2016)
- Kim DH, "Clinical and laboratory features of various criteria of eosinophilic chronic rhinosinusitis : a systematic review and meta-analysis", Clin Exp Otorhinolaryngol, 15(3), pp.230~246 (2022)
- Park DY, "Clinical practice guideline : nasal irrigation for chronic rhinosinusitis in adults", Clin Exp Otorhinolaryngol, 15(1), pp.5~23 (2022)
- DeConde AS, "Comparative effectiveness of medical and surgical therapy on olfaction in chronic rhinosinusitis : a prospective, multi-institutional study", Int Forum Allergy Rhinol, 4(9), pp.725~733 (2014)
- Desrosiers M, "Dupilumab reduces systemic corticosteroid use and sinonasal surgery rate in CRSwNP", Rhinology, 59(3), pp.301~311 (2021)
- Hopkins C, "Ethical dilemmas associated with the introduction of biologic treatments in chronic rhinosinusitis with nasal polyps", Rhinology, 60(3), pp.162~168 (2022)
- Kim DH, "Considerations for the use of biologic agents in patients with chronic rhinosinusitis with nasal polyposis", Clin Exp Otorhinolaryngol, 14(3), pp.245~246 (2021)
- Fokkens WJ, "EPOS", EUFOREA update on indication and evaluation of biologics in chronic rhinosinusitis with nasal polyps 2023, 2023, pp.61(3), 194~202
- Atalay S, "Serum drug levels and anti-drug antibodies in the context of dose tapering by interval prolongation of adalimumab, etanercept and ustekinumab in psoriasis patients : results of the CONDOR trial", J Dermatolog Treat, 33(5), pp.2680~2684 (2022)
- Chen MM, "An international, retrospective study of off-label biologic use in the treatment of hypereosinophilic syndromes", J Allergy Clin Immunol Pract, 10(5), pp.1217~1228 (2022)
- Meyer MK, "Personalized rheumatic medicine through dose reduction reduces the cost of biological treatment : a retrospective intervention analysis", Scand J Rheumatol, 48(5), pp.398~407 (2019)
- Little DH, "Effectiveness of dose de-escalation of biologic therapy in inflammatory bowel disease : a systematic review", Am J Gastroenterol, 115(11), pp.1768~1774 (2020)
- Spekhorst LS, "Patient-centered dupilumab dosing regimen leads to successful dose reduction in persistently controlled atopic dermatitis", Allergy, 77(11), pp.3398~3407 (2022)
- Isabwe GA, "Hypersensitivity reactions to therapeutic monoclonal antibodies : phenotypes and endotypes", J Allergy Clin Immunol, 142(1), pp.159~170 (2018)
- Akram MS, "Challenges for biosimilars : focus on rheumatoid arthritis", Crit Rev Biotechnol, 41(1), pp.121~153 (2021)
- Gholami A, "Cost-effectiveness analysis of biopharmaceuticals for treating rheumatoid arthritis : infliximab, adalimumab, and etanercept", Biomed Res Int, 2021, pp.4450162~ (2021)
- Ahn CS, "Cost effectiveness of biologic therapies for plaque psoriasis", Am J Clin Dermatol, 14(4), pp.315~326 (2013)
- McQueen RB, "Cost-effectiveness of biological asthma treatments : a systematic review and recommendations for future economic evaluations", Pharmacoeconomics, 36(8), pp.957~971 (2018)
- van der Lans RJ, "Biologicals and endoscopic sinus surgery for severe uncontrolled chronic rhinosinusitis with nasal polyps : an economic perspective", J Allergy Clin Immunol Pract, 10(6), pp.1454~1461 (2022)
- van der Lans RJ, "Real-life observational cohort verifies high efficacy of dupilumab for chronic rhinosinusitis with nasal polyps", Allergy, 77(2), pp.670~674 (2022)