Dupilumab improves health-related quality of life in patients with chronic rhinosinusitis with nasal polyposis

Claus Bachert, Peter W. Hellings, Joaquim Mullol, Daniel L. Hamilos, Philippe Gevaert, Robert M. Naclerio, Vijay N. Joish, Jingdong Chao, Leda P. Mannent, Nikhil Amin, Adeline Abbe, Christine Taniou, Chunpeng Fan, Gianluca Pirozzi, Neil M.H. Graham, Puneet Mahajan, Heribert Staudinger, Asif Khan

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) negatively affects health-related quality of life (HRQoL). In a previously reported randomized clinical trial (NCT01920893), addition of dupilumab to mometasone furoate in patients with CRSwNP refractory to intranasal corticosteroids (INCS) significantly improved endoscopic, radiographic, and clinical endpoints and patient-reported outcomes. The objective of this analysis was to examine the impact of dupilumab treatment on HRQoL and productivity using secondary outcome data from this trial. Methods: Following a 4-week mometasone furoate nasal spray run-in, patients were randomized to commence subcutaneous dupilumab (600 mg loading dose, then 300 mg once weekly for 15 weeks [n = 30], or matched placebo [n = 30]). Outcomes included scores on the CRS disease severity visual analog scale (VAS), 22-item Sino-Nasal Outcome Test (SNOT-22), 5-dimension EuroQoL (EQ-5D) general health status VAS, and 36-item Short-Form Health Survey (SF-36) for HRQoL and nasal polyp-related healthcare resource use questionnaires. Results: Following 16 weeks of treatment, the proportion of patients with moderate-to-severe CRSwNP (VAS > 3-10) decreased from 86.2% to 21.4% with dupilumab and 88.0% to 84.2% with placebo. Dupilumab (vs placebo) resulted in significantly greater improvement in HRQoL, based on SNOT-22, SF-36, and EQ-5D VAS scores. The dupilumab group had a significantly lower adjusted annualized mean number of sick leave days (0.09, vs 4.18 with placebo, P =.015) and significantly greater improvement (vs placebo) in the SNOT-22 item “reduced productivity.”. Conclusions: In adults with CRSwNP refractory to treatment with INCS alone, the addition of dupilumab reduced disease severity, significantly improved HRQoL, and improved productivity.

Original languageEnglish
Pages (from-to)148-157
Number of pages10
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume75
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • ENT (rhinitis
  • biologics
  • nasal polyps…)
  • quality of life
  • sinusitis

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