TY - JOUR
T1 - Dupilumab for the treatment of chronic rhinosinusitis with nasal polyposis
AU - Fokkens, Wytske
AU - van der Lans, Rik
AU - Reitsma, Sietze
N1 - Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) affects 1–2.5% of the population and is associated with significant adverse effects on quality of life (QoL). CRSwNP is strongly correlated with (late onset) asthma with 30–70% of the CRSwNP patients having asthma. Health-care spending in rhinosinusitis is high, especially because of indirect costs. Areas covered: In the last years, the recognition of endotyping as an essential presumption to precision medicine has significantly changed the integrated care pathways in the treatment of chronic rhinosinusitis. Dupilumab is the first biological available for the treatment of CRswNP, since late 2019. Treatment with dupilumab results in a significant improvement of QoL (measured as SNOT-22), rhinosinusitis disease severity, symptoms of rhinosinusitis, and especially sense of smell, nasal polyp score, Lund-Mackay CT score, and asthma outcomes (ACQ5 and FEV1) compared to placebo. Expert opinion: At this moment, the high cost of the treatment requires careful patient selection and within the EUFOREA and EPOS2020 context, experts have tried to give guidance based on today’s data. We now need trials evaluating which patients benefit most from treatment with biologicals and in which patients the treatment is cost-effective.
AB - Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) affects 1–2.5% of the population and is associated with significant adverse effects on quality of life (QoL). CRSwNP is strongly correlated with (late onset) asthma with 30–70% of the CRSwNP patients having asthma. Health-care spending in rhinosinusitis is high, especially because of indirect costs. Areas covered: In the last years, the recognition of endotyping as an essential presumption to precision medicine has significantly changed the integrated care pathways in the treatment of chronic rhinosinusitis. Dupilumab is the first biological available for the treatment of CRswNP, since late 2019. Treatment with dupilumab results in a significant improvement of QoL (measured as SNOT-22), rhinosinusitis disease severity, symptoms of rhinosinusitis, and especially sense of smell, nasal polyp score, Lund-Mackay CT score, and asthma outcomes (ACQ5 and FEV1) compared to placebo. Expert opinion: At this moment, the high cost of the treatment requires careful patient selection and within the EUFOREA and EPOS2020 context, experts have tried to give guidance based on today’s data. We now need trials evaluating which patients benefit most from treatment with biologicals and in which patients the treatment is cost-effective.
KW - Chronic rhinosinusitis
KW - EPOS2020
KW - biological
KW - dupilumab
KW - nasal polyps
UR - http://www.scopus.com/inward/record.url?scp=85103569009&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/14712598.2021.1901881
DO - https://doi.org/10.1080/14712598.2021.1901881
M3 - Article
C2 - 33724109
SN - 1471-2598
VL - 21
SP - 575
EP - 585
JO - Expert Opinion on Biological Therapy
JF - Expert Opinion on Biological Therapy
IS - 5
ER -