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Radiological Versus Clinical 1‐Year Outcomes of Dupilumab in Refractory CRSwNP: A Real‐Life Study

Giombi, Francesco ; Pace, Gian Marco ; Nappi, Emanuele ; Giunta, Gianmarco ; Muci, Giovanna ; Pirola, Francesca ; Ferreli, Fabio ; Heffler, Enrico ; Paoletti, Giovanni ; Giannitto, Caterina ; Mercante, Giuseppe ; Francone, Marco ; Spriano, Giuseppe ; Canonica, Giorgio Walter ; Malvezzi, Luca

The Laryngoscope, 2024-06, Vol.134 (6), p.2626-2633 [Periódico revisado por pares]

Hoboken, USA: John Wiley & Sons, Inc

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Título:
Radiological Versus Clinical 1‐Year Outcomes of Dupilumab in Refractory CRSwNP: A Real‐Life Study
Autor: Giombi, Francesco ; Pace, Gian Marco ; Nappi, Emanuele ; Giunta, Gianmarco ; Muci, Giovanna ; Pirola, Francesca ; Ferreli, Fabio ; Heffler, Enrico ; Paoletti, Giovanni ; Giannitto, Caterina ; Mercante, Giuseppe ; Francone, Marco ; Spriano, Giuseppe ; Canonica, Giorgio Walter ; Malvezzi, Luca
Assuntos: Adult ; Aged ; Antibodies, Monoclonal, Humanized - therapeutic use ; Chronic Disease ; chronic rhinosinusitis ; CT scan ; dupilumab ; Endoscopy ; Endoscopy - methods ; Female ; Humans ; Lund Mackay ; Male ; Medical imaging ; Middle Aged ; Nasal Polyps - complications ; Nasal Polyps - drug therapy ; Patient Reported Outcome Measures ; patients reported outcomes ; Polyps ; Retrospective Studies ; Rhinitis - drug therapy ; Severity of Illness Index ; Sinusitis - diagnostic imaging ; Sinusitis - drug therapy ; Tomography, X-Ray Computed ; Treatment Outcome
É parte de: The Laryngoscope, 2024-06, Vol.134 (6), p.2626-2633
Notas: The authors have no funding, financial relationships, or conflicts of interest to disclose.
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Descrição: Objective To provide real‐life evidence on long‐term radiological changes in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP) treated with dupilumab, and to assess possible differences between radiological and clinical results in terms of endoscopic findings and Patient‐Reported‐Outcomes (PROs). Methods Consecutive patients treated with dupilumab for recalcitrant CRSwNP were required to undergo CT scan at baseline (T0) and after 12 (T1) since first administration. A group of patients also performed CT scan at 52 weeks (T2) to assess long‐term outcomes. At each timepoint, patients underwent nasal endoscopy, assessment of Nasal‐Polyp‐Score (NPS), Lund‐Kennedy‐Score (LKS), and had to fill in the 22‐item Sinonasal‐Outcome‐Test (SNOT‐22) and Visual‐Analogue‐Scales (VAS) for sinonasal symptoms. Results In fifty‐three included patients, from T0 to T1 we detected a significant reduction in mean Lund‐Mackay score (LM), PROs (SNOT‐22, VAS) and endoscopic (NPS, LKS) scores (p < 0.05). In the subset of patients that reached T2 (n = 30), compared to T1, we observed a further significant decrease in mean LM, SNOT‐22, VAS, and NPS scores, but not in LKS (p = 0.420). At T1, the highest improvement was observed in PROs (SNOT‐22: 56.26%), and polyp size (NPS: 49.83%). Conversely, between T1 and T2, sinus opacification was shown to be the most improved outcome (LM: 36.86%). Conclusions Our experience showed that poorly controlled CRSwNP patients treated with dupilumab experienced significant improvement in radiologic, endoscopic and clinical disease severity. While in the initial 3 months, PROs garnered attention for showing earlier effectiveness, radiological outcomes revealed sustained and gradual efficacy in a longer term. Level of Evidence Level 4. According to the Oxford Center for Evidence‐Based Medicine 2011 level of evidence guidelines, this non‐randomized retrospective cohort study is classified as level 4 evidence Laryngoscope, 134:2626–2633, 2024 Our study showed that poorly controlled CRSwNP patients treated with dupilumab experienced a significant enhancement in radiologic, endoscopic, and clinical disease severity. While in the initial three months, patient‐reported outcomes garnered attention for showing prompt effectiveness, radiological outcomes revealed sustained and gradual improvement in a longer term.
Editor: Hoboken, USA: John Wiley & Sons, Inc
Idioma: Inglês

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Radiological Versus Clinical 1‐Year Outcomes of Dupilumab in Refractory CRSwNP: A Real‐Life Study

Giombi, Francesco ; Pace, Gian Marco ; Nappi, Emanuele ; Giunta, Gianmarco ; Muci, Giovanna ; Pirola, Francesca ; Ferreli, Fabio ; Heffler, Enrico ; Paoletti, Giovanni ; Giannitto, Caterina ; Mercante, Giuseppe ; Francone, Marco ; Spriano, Giuseppe ; Canonica, Giorgio Walter ; Malvezzi, Luca

Hoboken, USA: John Wiley & Sons, Inc

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