T helper 2 inflammatory markers are associated with recurrence in chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery

Mortuaire, G.; Gengler, Isabelle; Carpentier, C; Szymanski, Claire; Chenivesse, Cécile; Lefèvre, G.

doi:10.4193/rhin19.439

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…Evidence of type 2 inflammation is one criterion for initiating treatment with the biologics currently available for CRSwNP ( statement 22 ) [ 1 , 10 ]. However, strategies that allow more accurate identification of patients eligible for biologics, and specific biomarkers and tools for assessing response to biologics, are currently lacking and are the subjects of intense research [ 10 , 54 , 55 , 74 , 76 , 77 , 78 , 79 ]. What constitutes “clear evidence” of type 2 inflammation is yet to be determined ( see statement 8 ).…”

Section: Resultsmentioning

confidence: 99%

Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement

Corso

Bilò

Matucci

et al. 2022

JPM

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Chronic rhinosinusitis (CRS) is a sino-nasal chronic inflammatory disease, occurring in 5–15% of the general population. CRS with nasal polyps (CRSwNP) is present in up to 30% of the CRS population. One-third of CRSwNP patients suffer from disease that is uncontrolled by current standards of care. Biologics are an emerging treatment option for patients with severe uncontrolled CRSwNP, but their positioning in the treatment algorithm is under discussion. Effective endotyping of CRSwNP patients who could benefit from biologics treatment is required, as suggested by international guidelines. Other issues affecting management include comorbidities, such as allergy, non-steroidal anti-inflammatory drug–exacerbated respiratory disease, and asthma. Therefore, the choice of treatment in CRSwNP patients depends on many factors. A multidisciplinary approach may improve CRSwNP management in patients with comorbidities, but currently there is no shared management model. We summarize the outcomes of a Delphi process involving a multidisciplinary panel of otolaryngologists, pulmonologists, and allergist-immunologists involved in the management of CRSwNP, who attempted to reach consensus on key statements relating to the diagnosis, endotyping, classification and management (including the place of biologics) of CRSwNP patients.

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Section: Resultsmentioning

confidence: 99%

Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement

Corso

Bilò

Matucci

et al. 2022

JPM

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“…The relationship between serum total IgE levels and the recurrence of nasal polyps remains inconclusive. [40][41][42] Some biotherapeutics, such as monoclonal antibodies against IgE, have been proposed as novel treatments for severe nasal polyps. 43 The association between serum IgE and the treatment response of nasal polyps in varied endotypes deserves further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…The impact of AD on the recurrence of nasal polyps probably stemmed from its higher ECP level, so it was not significant in the multivariate regression analysis. The relationship between serum total IgE levels and the recurrence of nasal polyps remains inconclusive 40‐42 . Some biotherapeutics, such as monoclonal antibodies against IgE, have been proposed as novel treatments for severe nasal polyps 43 .…”

Section: Discussionmentioning

confidence: 99%

Serum eosinophil cationic protein: a prognostic factor for early postoperative recurrence of nasal polyps

Lee

Huang

et al. 2020

Int Forum Allergy Rhinol

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Background The objective of this work was to assess the efficacy of serum eosinophil cationic protein ECP concentration in predicting early postoperative recurrence in patients with chronic rhinosinusitis with nasal polyps CR-SwNP Methods We prospectively enrolled CRSwNP patients to receive bilateral functional endoscopic sinus surgery FESS and followed them for year Serum ECP level was measured within week before surgery Demographics and associated medical factors were analyzed with the surgical outcome and nasal polyp histology was microscopically examined Results Overall patients met the inclusion criteria and underwent FESS A er at least a-year follow-up period patients had postoperative recurrence with significantly higher serum ECP levels p = Receiver operating characteristic curve analysis showed the optimal cutoff level of serum ECP concentration for predicting the postoperative recurrence of nasal polyps was μg/L p = Regardless of atopy status and histology type logistic regression analysis showed that a higher ECP level was the sole significant factor related to early postopera-tive recurrence of nasal polyps odds ratio p = Cox proportional hazard regression analysis revealed that the hazard ratio of CRSwNP patients with an ECP level of > μg/L resulting in early postoperative recurrence was p = Conclusion Serum ECP appears to be a feasible predictor for early postoperative recurrence of nasal polyps CRSwNP patients with preoperative serum ECP levels of ≥ μg/L had an approximately-fold increased risk of early recurrence CRSwNP patients with higher preoperative serum ECP levels should be closely monitored within the first year a er surgery © 2020 ARS-AAOA, LLC.

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“…Total (% of total) 441 (100%) 151 (34.0%) 39 (8.2%) that would go on to receive revision surgery will give policymakers an indicator of the number of eligible patients when deciding on a national implementation strategy for biological treatment for CRSwNP. We base the assumption of these patients being a surrogate for eligible patients on the generally accepted fact that patients with CRSwNP are characterised by type 2 inflammation (17,18) and that high rates of verified comorbid asthma as high as 65% have been reported in operated patients (19) . Moreover, with a prevalence of 74-100% in re-operated patients when tested with more sophisticated tests, loss of smell is described as a major symptom, with between 76-98% of reoperated patients having anosmia (20)(21)(22) .…”

Section: It Is Our Opinion That Patients Receiving Multiple Surgeries...mentioning

confidence: 99%

The potential role of biological treatment of chronic rhinosinusitis with nasal polyps: a nationwide cohort study

Eriksen¹,

Jakobsen²,

Aanæs³

et al. 2021

Rhin

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Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) can be a challenge to treat despite appropriate pharmacological therapy and endoscopic sinus surgery. With the introduction of biological treatment, costs will increase. In this study, we determine the number of patients with CRSwNP treated with endoscopic sinus surgery and revision surgery and thereby fulfil the main criterion for treatment with biologics in the newest European guidelines. Furthermore, we estimate a potential number of recipients of biologics nationwide. Methods: All adult patients registered in the Danish National Patient Registry as having undergone first endoscopic sinus surgery for CRSwNP from 2012–2018 were included. The number of operations, surgery dates, and comorbidities were extracted. The Kaplan-Meier method was used to calculate the revision rate over time. Revision surgery was used as a surrogate to determine the pool of potential recipients of biologics, as these would fulfil the eligibility criteria and ensure the necessary cost-effectiveness. Results: A total of 4667 operated patients with CRSwNP were included out of a population of 4.7 million adults (incidence 14/100,000 person-years). Approximately 18% (120 per year) was estimated to have revision surgery within seven years. The median time to revision surgery was 22 months. Of all analysed patients, 21% had registered asthma and/or allergic rhinitis, while these diseases were registered in 34% of patients treated with revision surgery. Conclusion: In Denmark, an average of 120 operated patients annually will have revision surgery within seven years and may benefit from treatment with biologics as an alternative option to revision surgery.

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T helper 2 inflammatory markers are associated with recurrence in chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery

Cited by 13 publications

References 27 publications

Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement

Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement

Serum eosinophil cationic protein: a prognostic factor for early postoperative recurrence of nasal polyps

The potential role of biological treatment of chronic rhinosinusitis with nasal polyps: a nationwide cohort study

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