Treatment of eosinophilic otitis media with pegylated interferon‐α 2a and 2b

Neff, Brian A.; Voss, Stephen G.; Carlson, Matthew L.; O’Brien, Erin; Butterfield, Joseph H.

doi:10.1002/lary.26303

Cited by 14 publications

(5 citation statements)

References 18 publications

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Section: Discussionmentioning

confidence: 99%

“…Our data build on growing evidence that control of the underlying eosinophilia is often necessary for symptomatic improvement of eosinophilic otitis media. For example, aggressive asthma control has also been shown to provide clinical improvement (22,23) as has treatment with pegylated interferon-α 2a or 2b and ramatroban (24). The role of surgery in the treatment of this disease appears to be limited.…”

Section: Discussionmentioning

confidence: 99%

“…The role of surgery in the treatment of this disease appears to be limited. No surgical treatment has demonstrated consistent improvement, but removal of granulation tissue may provide symptomatic relief and make topical treatments more effective (1,24). Curiously, a corollary measure of eosinophilia, objective nasal endoscopy findings, also did not improve significantly with biologic therapy relative to the control group.…”

Section: Discussionmentioning

confidence: 99%

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Improvement of Suspected Eosinophilic Otitis Media with Targeted Biologic Therapy

2023

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ObjectiveTo compare the responses of suspected eosinophilic otitis media to treatment with or without a targeted biologic therapy against interleukin-4 (IL-4), IL-5, or IL-13 signaling.Study DesignRetrospective review.SettingTertiary referral center.PatientsSubjects with type 2 chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and otitis media who underwent treatment between 2005 and 2021.InterventionTreatment with targeted biologic therapy.Main Outcome MeasuresPre- and posttreatment nasal endoscopy, ear examination, and audiologic evaluation.ResultsFour hundred seventy-seven subjects with type 2 CRSwNP were treated between 2005 and 2021. Sixty-two had otitis media with pre- and posttreatment evaluation. Retrospective chart review assessed pre- and posttreatment exam findings, nasal endoscopy, audiometry, and tympanometry. Nineteen subjects received a biologic therapy, whereas 43 did not. Exam, endoscopy, and tympanometry were graded for severity and compared pre- and posttreatment. Subjective ear exam and tympanometry were significantly improved with biologic therapy (control = 0.05, biologic = 0.84, p = 9.3 × 10−5; control = −0.1, biologic = 0.62, p = 0.0002). Conductive hearing loss as assessed by air–bone gaps did not change between groups (control = 1.2 dB better, biologic = 1.2 dB worse, p = 0.32). Nasal endoscopy findings improved with biologic therapy relative to the control group, although not statistically significant (control = 1.04, biologic = 1.36, p = 0.22).ConclusionsBiologic therapies targeting interleukin-4 (IL-4), IL-5, and IL-13 signaling are potential new treatments for eosinophilic otitis media. This is the largest study demonstrating improvement in subjects with suspected eosinophilic otitis media in response to biologic therapy, and immune modulation represents a novel treatment strategy for this challenging condition.Professional Practice Gap and Educational NeedCurrent treatment strategies for otologic symptoms in eosinophilic disease are not tremendously effective or durable, resulting in a need for improved treatment options.Learning ObjectiveTo determine if targeted biologic therapy, often used for eosinophilic asthma and type 2 chronic rhinosinusitis with nasal polyposis, improves coexistent suspected eosinophilic otitis media.Desired ResultTreatment of suspected eosinophilic otitis media with targeted biologic therapy will result in improvement of otologic symptoms with a durable response compared with current treatment options.Level of EvidenceLevel IV.Indicate IRB or IACUCExempt. HUM00182703.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Improvement of Suspected Eosinophilic Otitis Media with Targeted Biologic Therapy

2023

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“…The authors observed a satisfactory clinical response, with complete resolution of otorrhea, normalization of the middle ear mucosa and discontinuation of corticosteroid therapy in 50% of the cases. 38 Considering these facts, the aim of the present study was to investigate in vitro whether IFN-α alters the cytokine profile of eosinophilic CRSwNP, which is known to have a predominant Th2 pattern.…”

Section: Discussionmentioning

confidence: 99%

Interferon-α action in cytokine profile in eosinophilic nasal polyp cultures

Sousa

Etchbehere

Alves

et al. 2021

Brazilian Journal of Otorhinolaryngology

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“…Systemic and topical corticosteroids have been the main treatments for EOM because of their effectiveness. Recently, recombinant humanized monoclonal anti-IgE antibody therapy (omalizumab) [ 31 ] and pegylated interferon [ 32 ] have been reported to be effective for EOM. Omalizumab improves the subjective symptoms and clinical characteristics, and pegylated interferon also improves the clinical findings.…”

Section: Discussionmentioning

confidence: 99%

Optimal control of asthma improved eosinophilic otitis media

Seo

Nonaka

Yamamura

et al. 2018

Asia Pacific Allergy

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BackgroundEosinophilic otitis media (EOM) is often associated with comorbid asthma. The middle ear cavity is part of the upper airway. Therefore, EOM and asthma can be considered to be a crucial part of the “one airway, one disease” phenomenon. Based on the concept of one airway, one disease in the context of allergic rhinitis and asthma, optimal level of inhalation therapy for better asthma control leads to improvement in allergic rhinitis.ObjectiveWe conducted a pilot study to determine whether appropriate strengthening of inhalation therapy for asthma is effective for EOM.MethodsFifteen patients with EOM and comorbid asthma were enrolled in this study. Eight patients were randomly selected and administered appropriately strengthened inhalation therapy for asthma (strengthened group). The effect of the therapy on EOM was assessed by comparing a questionnaire for ear symptoms, clinical characteristic score, pure tone audiometry, blood tests and temporal bone computed tomography (CT) examination before and after the therapy. Seven other EOM + asthma patients without the above mentioned therapy were included as controls.ResultsIn the strengthened group, the score of ear symptoms, clinical characteristics score, peripheral blood eosinophil count, CT score, and air conduction hearing level improved significantly after strengthening the inhalation therapy, but not in the control group. The lung function tests (forced vital capacity [%predicted], forced expiratory volume in 1 second [FEV1] [L], and FEV1 [%predicted]) significantly increased in the strengthened group after the therapy, but not in the control group.ConclusionIn this study we demonstrated that EOM improved along with improved lung function when appropriately optimal inhalation therapy was implemented in patients with EOM and asthma. Administration of optimizing therapy for asthma might be effective for concomitant EOM.

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Treatment of eosinophilic otitis media with pegylated interferon‐α 2a and 2b

Abstract: 4. Laryngoscope, 127:1208-1216, 2017.

Cited by 14 publications

References 18 publications

Improvement of Suspected Eosinophilic Otitis Media with Targeted Biologic Therapy

Improvement of Suspected Eosinophilic Otitis Media with Targeted Biologic Therapy

Interferon-α action in cytokine profile in eosinophilic nasal polyp cultures

Optimal control of asthma improved eosinophilic otitis media

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