23 Mar Sinusitis With Nasal Polyps: Dupilumab Treatment Improves Sense of Smell

MedicalResearch.com Interview with:

Dr. Han

Joseph Han, MD FARS, FAAOA FAAAAI
Medical Director for the Division of Allergy
Eastern Virginia Medical School 

MedicalResearch.com: What is the background for this study?

Response: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease of the nasal passages and sinuses associated with a high symptom burden due to the chronic, relapsing nature of the disease. If you ask CRSwNP patients about the most important disease symptoms, they would say nasal congestion and decrease in smell. However, many CRSwNP patients would say that losing their sense of smell is particularly troublesome.

This study was conducted to better understand the effect of dupilumab, which is approved in the U.S. for adults with uncontrolled CRSwNP, on sense of smell.  

MedicalResearch.com: What are the main findings? 

Response: The Phase 3 SINUS-52 and SINUS-24 trials showed that dupilumab improved sense of smell in chronic rhinosinusitis with nasal polyps patients at Week 24. At the beginning of the trials, 77.6% of patients were without sense of smell (anosmic). After 24 weeks, 28% of patients treated with dupilumab were anosmic compared to 77.1% on placebo.

MedicalResearch.com: What should readers take away from your report?

Response: Dupilumab has shown significant improvement in sense of smell for patients with chronic rhinosinusitis with nasal polyps patients in clinical trials, and is the only approved biologic for this population. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: One interesting question would be to see if Dupixent has an immunomodulatory effect in the CRSwNP patients who have received this treatment.

MedicalResearch.com: Is there anything else you would like to add? 

Response: From the dupilumab clinical trials, we have learned that IL-4 and IL-13 are key drivers of the type 2 inflammation underlying chronic rhinosinusitis with nasal polyps patients and several other diseases, including asthma and atopic dermatitis. This is important, because the incidence of asthma patients with nasal polyps can be high, even as high as 60%. So it is no surprise in the SINUS-52 and SINUS-24 results that dupilumab was found to not only help patients with chronic rhinosinusitis with nasal polyps patients (upper respiratory inflammation), but also improve their comorbid asthma (lower respiratory inflammation).

The detailed Phase 3 results from the SINUS-52 and SINUS-24 trials of dupilumab in adults with chronic rhinosinusitis with nasal polyps patients were published in The Lancet at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31881-1/fulltext.

The abstract of the sense of smell study will be published online on The Journal of Allergy and Clinical Immunology: https://annualmeeting.aaaai.org/.

Disclosure: Sanofi – advisory board member.

 Citation:

Dupilumab Treatment Improves Sense of Smell in Patients With Chronic Rhinosinusitis With Nasal Polyps – Pooled Results From the SINUS-24 and SINUS-52 Phase 3 Trials
Mullol, Joaquim et al.
Journal of Allergy and Clinical Immunology, Volume 145, Issue 2, AB169 

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Last Updated on March 23, 2020 by Marie Benz MD FAAD