“Smell improvement by anti-IgE and anti-IL 5 biologics in patients with CRSwNP and severe asthma– A real life study”

Abstract

Background. Chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by partial (hyposmia) or total (anosmia) loss of smell, is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), worsens disease severity and quality of life. The objective of this study was to determine whether, in real-life conditions, biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare smell improvement in N-ERD and non-N-ERD subgroups. Methods. A multicenter, non-interventional, retrospective, observational study was performed, including 206 patients with severe asthma undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab) with CRSwNP. Results. Improved olfaction was found after treatment with all monoclonal antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab (35.7%), and benralizumab (39.1%), with no differences between groups. Patients with atopy, greater use of short course systemic corticosteroids, and larger polyp size were more likely to experience improvement in smell. The proportion of patients experiencing smell improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. Conclusions. This is the first study to compare real-life improvement in sense of smell among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in sense of smell (with non-significant differences between biologic drugs). No differences were found in smell improvement between the N-ERD and non-N-ERD group.

Olfactory Function and Biologic Treatments: Comment on Available Real-Life Studies

“…We would like to make a few comments on areas not addressed by the authors. Meier et al [3] reported similar results 2 years ago, and it is reassuring to see their poor outcome for olfactory function confirmed by Barroso et al [1]. They also compared 3 MABs (mepolizumab, omalizumab, and benralizumab), showing that all 3 treatments had moderate success rates for control of CRS, olfaction, and other symptoms, with mepolizumab performing best.…”

“…We read with interest the recent article by Barroso et al [1] on improvement in olfaction in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) and asthma who received monoclonal antibodies (MABs).…”

“…The clinical impression of the efficiency of MAB-based treatments is sometimes less convincing than shown in the initial trials [2]. Studies such that of Barroso et al [1] help to further refine the indication for MABs.…”

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We wish to thank Landis et al [1] for their letter regarding our work on the evolution of olfactory function in patients with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) Manuscript

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Omalizumab: a quarter of a century in the fight against T2-inflammatory diseases of upper and lower respiratory tract

“…Обоняние с большей вероятностью улучшалось у пациентов с атопией, более частым применением СГКС коротким курсом и большим размером полипов. Доля пациентов, у которых улучшилось обоняние, была одинаковой в группах как с гиперчувствительностью к нестероидным противовоспалительным препаратам (37%), так и без нее (35,7%) [108]. Таблица 6.…”