Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis

Nakashima, D; Minagawa, Syunsuke; Adachi, Tomohiko; Mitsuyama, Chieko; Shida, Yoko; Nakajima, Tsuneya; Haruna, Shinichi; Matsuwaki, Yoshinori

doi:10.1016/j.alit.2023.03.007

Cited by 7 publications

(1 citation statement)

References 23 publications

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“…A notable feature in this case is that the patient responded poorly to various antibody drugs, including anti-IgE, anti-IL-5, and anti-IL-4α antibodies. These drugs have been shown to effectively reduce eosinophilic inflammation and improve symptoms in patients with ECRS and EOM [5,6,[9][10][11]. Previous reports have not identified factors predicting poor responses to antibody drugs for ECRS or EOM.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Eosinophilic Chronic Rhinosinusitis With Concurrent Eosinophilic Otitis Media: Limited Responsiveness to Multiple Antibody Therapies and Subsequent Cochlear Implantation

Urabe,

Ohta,

Fujii

et al. 2023

Cureus

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Eosinophilic chronic rhinosinusitis (ECRS) and eosinophilic otitis media (EOM) are debilitating inflammatory conditions that affect the paranasal sinuses and middle ear, respectively, and are characterized by eosinophilic infiltration. This study describes a rare and intricate case of a 65-year-old male patient concurrently afflicted with ECRS, EOM, and bronchial asthma. Despite the systematic administration of corticosteroids and various antibody drugs, the patient's condition remained unimproved, necessitating a cochlear implant for EOM, which is seldom an aggressive intervention. The patient had a history of symptoms dating back to 2005, with notable exacerbations and treatment resistance over the years. Multiple antibody drugs, including anti-IgE, anti-IL-5, and anti-IL-4α antibodies, failed to ameliorate the patient's condition, presenting a significant clinical challenge. Pathological examination revealed marked eosinophilic infiltration and severe fibrosis, suggesting a possible mechanism underlying the poor response to antibody therapy. Cochlear implantation significantly enhanced the patient's communicative abilities. This case highlights the limitations of the current antibody drugs in managing severely intertwined cases of ECRS, EOM, and bronchial asthma, highlighting the need for novel therapeutic strategies. This case also propounds cochlear implantation as an efficacious intervention for refractory EOM with severe sensorineural hearing impairment, extending the spectrum of treatment modalities for such challenging scenarios. This singular case contributes to the growing body of evidence regarding the management of ECRS and EOM, especially against the backdrop of treatment resistance, and can aid clinicians in identifying and navigating similar complex cases in clinical practice.

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Section: Discussionmentioning

confidence: 99%

An Unusual Case of Eosinophilic Chronic Rhinosinusitis With Concurrent Eosinophilic Otitis Media: Limited Responsiveness to Multiple Antibody Therapies and Subsequent Cochlear Implantation

Urabe,

Ohta,

Fujii

et al. 2023

Cureus

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Characterization of microbial diversity and eosinophilic otitis media biomarkers using next-generation sequencing

Ii,

Noguchi,

Adachi

et al. 2024

Auris Nasus Larynx

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Dupilumab in the Treatment of Eosinophilic Otitis Media: A Case Report

Kim,

Jin,

Kim

et al. 2024

Korean J Otorhinolaryngol-Head Neck Surg

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Eosinophilic otitis media (EOM) differs from classic chronic otitis media as it is a refractory disease with the accumulation of eosinophils in thick mucinous middle ear effusion and mucosa. A 66-year-old male with a history of asthma, chronic sinusitis with polyposis, nasal polyposis, and multiple sets of ventilation tubes was presented to our center for the management of hearing loss and otorrhea. He had a history of consistent otorrhea and hearing loss even with the ventilation tube insertions and medical treatment. Both systemic and intratympanic steroid was administered, but the effect was insignificant and other systemic adverse effects occurred. Finally, the otologic symptoms including hearing loss and otorrhea improved after being given a Dupilumab injection. This case report discusses Dupilumab treatment resulting in remission in a patient suffering from refractory EOM.

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Dupilumab improves eosinophilic otitis media associated with eosinophilic chronic rhinosinusitis

Cited by 7 publications

References 23 publications

An Unusual Case of Eosinophilic Chronic Rhinosinusitis With Concurrent Eosinophilic Otitis Media: Limited Responsiveness to Multiple Antibody Therapies and Subsequent Cochlear Implantation

An Unusual Case of Eosinophilic Chronic Rhinosinusitis With Concurrent Eosinophilic Otitis Media: Limited Responsiveness to Multiple Antibody Therapies and Subsequent Cochlear Implantation

Characterization of microbial diversity and eosinophilic otitis media biomarkers using next-generation sequencing

Dupilumab in the Treatment of Eosinophilic Otitis Media: A Case Report

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