Outcomes of Biological Therapy in Patients with Severe Asthma with Chronic Rhinosinusitis in Saudi Arabia: Patients with Nasal Polyps Versus Those Without Nasal Polyps

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2024 Jul 8

PMID 38978039

Authors

Usama E Abuelhassan

Medhat Elnamaky

Abdulaziz Alfifi

Sultan K Kadasah

Mohammed A Alshehri

Haneen A Alasiri

Salihah Y Al-Mani

Ali S Kadasah

Abdullah Musleh

Fawwaz A Alshafa

Muhammad S S Qureshi

Abdulmohsen Y Assiri

Abdulrahman I Falqi

Bader I Asiri

Haider M O Ahmed

Saleem Alshehri

Fasih U Rahman

Muhammad Amir Qureshi

Omar Abdelwahab

Sherif Mohamed

Ahmed R I Ali

Saad M A Alqahtani

Abdelrahman M Abdalla

Affiliations

Soon will be listed here.

Abstract

Background: This study's purposes were to evaluate the impact of biological therapies on outcomes in patients with severe asthma (SA) and chronic rhinosinusitis (CRS) and to compare these effects among those with NP (CRSwNP) versus those without NP (CRSsNP) in the "real-world" setting in Saudi Arabian patients.

Methods: From March to September 2022, a retrospective observational cohort study was undertaken at the severe asthma clinics of the Armed Forces Hospital-Southern Region (AFHSR) and King Khalid University Hospital, Abha, Saudi Arabia, to delineate the effects of dupilumab therapy. Outcomes were assessed, including clinical outcomes, FEV1, and laboratory findings before and one year after dupilumab. Post-therapy effects were compared between CRSwNP and CRSsNP.

Results: Fifty subjects were enrolled, with a mean age of 46.56. There were 27 (54%) females and 23(46%) males. Significant improvements in clinical parameters (frequency of asthma exacerbations and hospitalizations, the use of OCs, anosmia, SNOTT-22, and the ACT), FEV1, and laboratory ones (serum IgE and eosinophilic count) were observed 6 and 12 months after using dupilumab (p < 0.001), respectively. However, after 12 months of dupilumab therapy, there were no significant differences between those with and without NP with regards to clinical (anosmia, ACT, and OCs use), laboratory (eosinophilic count, serum IgE level) parameters, and FEV1%.

Conclusions: Patients with CRS experienced significant improvements in clinical, FEV1, and laboratory outcomes after dupilumab therapy. However, these improvements were not maintained when comparing CRSwNP with CRSsNP. There were no significant differences between those with and without NP regarding ACT and OCs use or laboratory (eosinophilic count, serum IgE level) parameters. Further prospective multicenter studies are warranted.

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