Effect of Tezepelumab on Sino-Nasal Outcome Test (SNOT)-22 Domain and Symptom-Specific Scores in Patients with Severe, Uncontrolled Asthma and a History of Chronic Rhinosinusitis with Nasal Polyps.

IF 3.4 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-11-08 DOI:10.1007/s12325-024-03006-5
Joshua S Jacobs, Joseph K Han, Jason K Lee, Tanya M Laidlaw, Nicole L Martin, Scott Caveney, Christopher S Ambrose, Neil Martin, Joseph D Spahn, Flavia C L Hoyte
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Abstract

Introduction: Tezepelumab blocks the activity of thymic stromal lymphopoietin, an epithelial cytokine implicated in the pathogenesis of asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). In a previous analysis, tezepelumab improved asthma and rhinosinusitis symptoms compared with placebo in patients with severe, uncontrolled asthma and a history of CRSwNP in the 2 years before randomization in the NAVIGATOR study. This post hoc analysis of patients with a CRSwNP diagnosis at any time before randomization in NAVIGATOR enabled domain and symptom-specific analyses of Sino-Nasal Outcome Test (SNOT)-22 outcomes.

Methods: Patients (aged 12-80 years) with severe, uncontrolled asthma were randomized to tezepelumab 210 mg or placebo subcutaneously every 4 weeks for 52 weeks. SNOT-22 total, domain, and item scores were assessed in patients with a history of CRSwNP. Annualized asthma exacerbation rate (primary efficacy outcome), pre-bronchodilator forced expiratory volume in 1 s, and Asthma Control Questionnaire-6, Asthma Quality of Life Questionnaire (standardized) for patients 12 years and older, and Asthma Symptom Diary scores were also assessed in patients with and without a history of CRSwNP.

Results: Of 1059 patients with severe asthma, 165 (15.6%) had a history of CRSwNP. Tezepelumab treatment resulted in sustained improvements versus placebo in SNOT-22 total score throughout the 52-week study period [least-squares mean difference (95% confidence interval) - 11.08 (- 17.80, - 4.35)]. Tezepelumab improved all five SNOT-22 domain scores (sleep, nasal, function, ear/facial, and emotion) and the five SNOT-22 item scores of most clinical interest (decreased sense of smell/taste, nasal blockage, reduced productivity, waking up tired, and cough). Tezepelumab improved asthma-related clinical outcomes in patients with and without a history of CRSwNP.

Conclusion: In patients with severe, uncontrolled asthma and a history of CRSwNP, tezepelumab improved rhinosinusitis symptoms across multiple domains, as well as asthma exacerbations, lung function, asthma control, and health-related quality of life.

Clinicaltrials:

Gov identifier: NCT03347279 ( https://classic.

Clinicaltrials: gov/ct2/show/NCT03347279 ).

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Tezepelumab 对重度、未控制哮喘且有慢性鼻炎伴鼻息肉病史患者的中国鼻科结果测试 (SNOT)-22 领域和症状特异性评分的影响。
简介胸腺基质淋巴细胞生成素是一种上皮细胞因子,与哮喘和慢性鼻炎伴鼻息肉(CRSwNP)的发病机制有关。在之前的一项分析中,与安慰剂相比,在NAVIGATOR研究中,与随机分组前两年内未得到控制的严重哮喘和有CRSwNP病史的患者相比,替塞单抗能改善哮喘和鼻炎症状。该研究对 NAVIGATOR 随机化前任何时间诊断出 CRSwNP 的患者进行了事后分析,从而对中鼻结果测试(SNOT)-22 结果进行了领域和症状特异性分析:患有严重、无法控制的哮喘的患者(12-80 岁)被随机分配到替塞普鲁单抗 210 毫克或安慰剂中,每 4 周皮下注射一次,共 52 周。对有 CRSwNP 病史的患者进行 SNOT-22 总分、领域分和项目分评估。此外,还评估了有CRSwNP病史和无CRSwNP病史患者的年化哮喘加重率(主要疗效结果)、支气管扩张前1 s用力呼气容积、哮喘控制问卷-6、12岁及以上患者哮喘生活质量问卷(标准化)和哮喘症状日记评分:在1059名重症哮喘患者中,165人(15.6%)有CRSwNP病史。在为期52周的研究中,特珠单抗治疗与安慰剂相比可持续改善SNOT-22总分[最小二乘平均差(95%置信区间)-11.08(-17.80,-4.35)]。特珠单抗改善了所有五个 SNOT-22 领域得分(睡眠、鼻腔、功能、耳/面部和情绪)以及临床上最感兴趣的五个 SNOT-22 项目得分(嗅觉/味觉减退、鼻塞、工作效率降低、疲倦醒来和咳嗽)。特珠单抗改善了有CRSwNP病史和无CRSwNP病史患者的哮喘相关临床结果:结论:对于病情严重、哮喘未得到控制且有 CRSwNP 病史的患者,替赛普鲁单抗可改善鼻炎症状的多个方面,以及哮喘加重、肺功能、哮喘控制和与健康相关的生活质量:Gov 标识符:NCT03347279 ( https://classic.Clinicaltrials: gov/ct2/show/NCT03347279 )。
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来源期刊
Advances in Therapy
Advances in Therapy 医学-药学
CiteScore
7.20
自引率
2.60%
发文量
353
审稿时长
6-12 weeks
期刊介绍: Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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Effect of Tezepelumab on Sino-Nasal Outcome Test (SNOT)-22 Domain and Symptom-Specific Scores in Patients with Severe, Uncontrolled Asthma and a History of Chronic Rhinosinusitis with Nasal Polyps. Therapeutic Applications for Homeopathy in Clinical Practice. A Retrospective Claims Analysis of the Rate of Complications in Patients Undergoing Treatment for Paroxysmal Nocturnal Hemoglobinuria. Clinical Characteristics and Treatment of Patients Diagnosed with Pulmonary Arterial Hypertension: A Real-World Study in the USA, Europe and Japan. Dosing Patterns of Dulaglutide and Semaglutide in Patients with Type 2 Diabetes Mellitus in France and Italy: A Retrospective Cohort Study.
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