Management of eosinophilic otitis media in the era of biological therapy: systematic review and proportion meta-analysis.

IF 4.8 2区医学 Q1 OTORHINOLARYNGOLOGY Rhinology Pub Date : 2024-12-29 DOI:10.4193/Rhin24.421

M Lazzeroni, H Elzinga, P Merkus, E van Spronsen, W J Fokkens, S Reitsma

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Abstract

Background: Eosinophilic otitis media (EOM) is a recently recognised type 2 inflammatory disease, strongly associated with asthma and chronic rhinosinusitis with nasal polyps. Known as a difficult-to-treat condition, EOM is often refractory to traditional therapies for (chronic) otitis media. This review aims to assess the success rates of the different interventions for patients with EOM including newly available biological therapy.

Methodology: In March 2024 we systematically searched PubMed, Embase, Scopus and Web of Science for studies on more than 5 EOM patients undergoing any medical or surgical intervention with a reported success rate. Proportion meta-analysis on a random effect model was used to synthesize results effectively. Risk of bias was assessed through the Risk Of Bias In Non randomized Studies of Interventions tool (ROBINS-I).

Results: From 1103 potential articles, 14 studies with 361 patients were included. 62% were females and 85% had bilateral presentation. Otorrhoea was present in 68% of patients, tympanic membrane perforation in 50%. The overall success rate was 61.3. However, interventions comprising biological agents targeting type 2 inflammatory cascade showed higher success rates compared to non-biological treatments.

Conclusions: A shift towards biologic-based therapies could be beneficial for managing the challenging condition EOM.

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生物治疗时代嗜酸性中耳炎的治疗：系统回顾和比例荟萃分析。

背景：嗜酸性中耳炎（EOM）是一种新近发现的2型炎症性疾病，与哮喘和慢性鼻窦炎合并鼻息肉密切相关。众所周知，EOM是一种难以治疗的疾病，对于（慢性）中耳炎的传统治疗方法通常是难治的。本综述旨在评估不同干预措施对EOM患者的成功率，包括最新的生物治疗。方法：在2024年3月，我们系统地检索了PubMed， Embase， Scopus和Web of Science，检索了超过5例接受任何医疗或手术干预的EOM患者的研究，并报告了成功率。采用随机效应模型的比例元分析有效地综合了结果。通过非随机干预研究的偏倚风险评估工具（ROBINS-I）评估偏倚风险。结果：从1103篇潜在文章中，纳入了14项研究，共361例患者。62%为女性，85%为双侧表现。68%的患者出现耳漏，50%的患者出现鼓膜穿孔。总成功率为61.3。然而，与非生物治疗相比，包括针对2型炎症级联的生物制剂的干预措施显示出更高的成功率。结论：转向以生物为基础的治疗可能有利于治疗具有挑战性的EOM。

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

Rhinology 医学-耳鼻喉科学

CiteScore

15.80

自引率

9.70%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Rhinology serves as the official Journal of the International Rhinologic Society and is recognized as one of the journals of the European Rhinologic Society. It offers a prominent platform for disseminating rhinologic research, reviews, position papers, task force reports, and guidelines to an international scientific audience. The journal also boasts the prestigious European Position Paper in Rhinosinusitis (EPOS), a highly influential publication first released in 2005 and subsequently updated in 2007, 2012, and most recently in 2020. Employing a double-blind peer review system, Rhinology welcomes original articles, review articles, and letters to the editor.