Effets rhino sinusiens des biothérapies chez l'asthmatique sévère

Abstract : Introduction: Chronic rhinosinusitis (CRS) is a common disease, and significantly impacts patient’s quality of life. It is frequently associated with severe asthma, and both share key elements in inflammatory mechanisms, hence the concept of « United Airways Disease ». Some patients, particularly those with severe CRS with nasal polyposis, are not controlled by usual treatments, leading to repeated sinus surgery without real benefit on the natural history of the disease. Here, we aimed to assess the efficacy of biotherapies used in severe asthma on the symptoms of CRS. Methods: We conducted a monocentric study at the North Hospital of Marseille. We enrolled severe asthmatic patients treated with biotherapy for at least 4 months (Omalizumab, Mepolizumab, Benralizumab or Reslizumab). Questionnaires assessing the patient-directed outcome measure, derived from SNOT-22 (SinoNasal Outcome Test) and ACQ (Asthma Control Questionnaire), were obtained. Results: 86 patients were included. 71% had an improvement of their CRS (100% with Omalizumab, 80% with Reslizumab, 75% with Benralizumab and 67% with Mepolizumab). In the multivariate analysis, independent predictors of response with anti IL5 were a high initial blood eosinophil count and a long-term treatment (median blood eosinophil count 1.22G/l vs 0.77G/l, p=0,0065 ; and median duration of treatment 50 months vs 22 months, p=0,0363). Conclusion: Anti IL5 and anti IgE monoclonal antibodies developed in severe asthma also impact CRS. Moreover, with anti IL5, this improvement is associated with a higher initial blood eosinophil count and a longer duration of treatment.
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Submitted on : Friday, July 5, 2019 - 10:33:16 AM
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Alice Leininger. Effets rhino sinusiens des biothérapies chez l'asthmatique sévère. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02174537⟩

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