Dupilumab improves sense of smell and clinical outcomes in patients with severe chronic rhinosinusitis with nasal polyps with anosmia

作者：Andrew P. Lane, Joaquim Mullol, Claire Hopkins, Wytske Johanna Fokkens, Stella E. Lee, Jérôme Msihid, Scott D. Nash, Harry J. Sacks, Kinga Borsos, Siddhesh Kamat, Paul J. Rowe, Yamo M. Deniz, Juby Anne Jacob-Nara · 发表于：Current Medical Research and Opinion · 年份：2024 · DOI：10.1080/03007995.2024.2434083 · 被引用次数：14 · 研究领域：Olfactory and Sensory Function Studies、Sinusitis and nasal conditions、Allergic Rhinitis and Sensitization

Objective Loss of sense of smell is a cardinal symptom of chronic rhinosinusitis with nasal polyps (CRSwNP) and significantly impacts health-related quality-of-life. Dupilumab significantly improved smell outcomes (loss of smell [LoS] score; University of Pennsylvania Smell Identification Test [UPSIT]) versus placebo in the phase 3 SINUS-24/-52 studies (clinicaltrials.gov, NCT02898454/NCT02912468) in patients with severe CRSwNP. This post hoc analysis investigated the effect of dupilumab on olfaction using UPSIT smell impairment categories.Methods Patients with baseline smell impairment (UPSIT ≤34/≤33 [women/men; score range 0–40] AND LoS score ≥1 [0–3] AND smell/taste item of the 22-item Sinonasal Outcome Test >0 [SNOT-22; 0–5]) treated with dupilumab 300 mg or placebo once every 2 weeks on background intranasal corticosteroids were analyzed.Results Of 724 patients, 665 (91.9%) had smell impairment at baseline; most had anosmia (UPSIT 0–18) (dupilumab/placebo: 80.9%/79.8%). At week 24, the proportion of dupilumab-treated patients with anosmia decreased to 28.5%, while 14.9% achieved normosmia; most placebo-group patients (79.2%) remained anosmic and only 1.2% achieved normosmia (odds ratio = 17.3; 95% confidence interval = 5.1–59.0; p <.0001); results were similar at week 52. Improvements in Nasal Polyp Score, nasal congestion, and SNOT-22 total score were moderately correlated with improvements in UPSIT at weeks 24 and 52 (r = −.38 to −.50).Conclusion Most patients with sev...