Comparative Effectiveness of Dupilumab Versus Sinus Surgery for Chronic Rhinosinusitis With Polyps: Systematic Review and a Meta-Analysis.

IF 2.5 3区医学 Q1 OTORHINOLARYNGOLOGY American Journal of Rhinology & Allergy Pub Date : 2024-11-01 Epub Date: 2024-08-16 DOI:10.1177/19458924241272978

Do Hyun Kim, Gulnaz Stybayeva, Se Hwan Hwang

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Abstract

Background: Current treatment paradigms recommend surgical intervention when conventional medical management proves ineffective in resolving chronic rhinosinusitis with nasal polyposis.

Objectives: To assess and compare the efficacy of dupilumab and functional endoscopic sinus surgery (FESS) for the treatment of chronic rhinosinusitis with nasal polyp (CRSwNP) over time.

Methods: Studies comparing CRSwNP patients who received dupilumab with those who underwent FESS were included. Outcome measures included the nasal congestion score (NCS), Sino-nasal Outcome Test-22 (SNOT-22), University of Pennsylvania Smell Identification Test-40 (UPSIT-40), and nasal polyp score (NPS). The risk of bias was evaluated using the Newcastle-Ottawa Scale.

Results: A total of 4 studies with 724 participants were included. The dupilumab group had a superior NCS, but an inferior NPS, compared to the FESS group during the follow-up period. The SNOT-22 score of the dupilumab group was inferior to that of the FESS group until 6 months posttreatment, but the scores were similar at around 1 year. A similar trend was observed for the UPSIT-40 score, but the score of the dupilumab group was higher at around 1 year.

Conclusion: Functional endoscopic sinus surgery was more effective than dupilumab for several months after treatment. However, at 1 year after treatment, the effects of the 2 treatments became similar, with greater olfactory improvement seen in the dupilumab group.

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杜比鲁单抗与鼻窦手术治疗慢性鼻窦炎伴息肉的疗效比较：系统综述与 Meta 分析。

背景：目前的治疗模式建议，当常规药物治疗无效时，应采取手术干预：目前的治疗范例建议，当常规药物治疗无法有效解决慢性鼻炎伴鼻息肉时，应采取手术干预：评估并比较双鲁单抗和功能性内窥镜鼻窦手术（FESS）治疗慢性鼻炎伴鼻息肉（CRSwNP）的疗效：方法：纳入对接受杜利鲁单抗治疗的 CRSwNP 患者与接受 FESS 治疗的 CRSwNP 患者进行比较的研究。结果测量包括鼻塞评分（NCS）、中鼻结果测试-22（SNOT-22）、宾夕法尼亚大学气味识别测试-40（UPSIT-40）和鼻息肉评分（NPS）。采用纽卡斯尔-渥太华量表对偏倚风险进行了评估：结果：共纳入了 4 项研究，共有 724 名参与者。在随访期间，与 FESS 组相比，dupilumab 组的 NCS 较高，但 NPS 较低。在治疗后 6 个月之前，dupilumab 组的 SNOT-22 评分低于 FESS 组，但在治疗后 1 年左右，两组的评分相近。UPSIT-40评分也有类似趋势，但双鲁单抗组在1年左右的评分更高：结论：在治疗后的几个月内，功能性内窥镜鼻窦手术比杜比鲁单抗更有效。结论：在治疗后的几个月内，功能性内窥镜鼻窦手术比杜比鲁单抗更有效，但在治疗一年后，两种治疗方法的效果变得相似，杜比鲁单抗组的嗅觉改善更大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Rhinology & Allergy 医学-耳鼻喉科学

CiteScore

5.60

自引率

11.50%

发文量

审稿时长

4-8 weeks

期刊介绍： The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.