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Biologics versus functional endoscopic sinus surgery for the treatment of chronic rhinosinusitis with nasal polyps: a literature review

Published online by Cambridge University Press:  23 November 2023

Asmaa Alshatti Open the ORCID record for Asmaa Alshatti [Opens in a new window]  and
Christopher Webb
Asmaa Alshatti*
Affiliation:
School of Medicine, University of Liverpool, Liverpool, UK
Christopher Webb
Affiliation:
Department of Otorhinolaryngology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
*
Corresponding author: Asmaa Alshatti; Email: [email protected]
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Abstract

Objective

To review the literature comparing functional endoscopic sinus surgery to dupilumab for the treatment of chronic rhinosinusitis with nasal polyps, in terms of symptom control, cost-effectiveness and complications.

Method

A literature review was conducted using PubMed, ScienceDirect and Cochrane databases. Data were extracted manually.

Results

A total of six papers relevant to the main objective were found.

Conclusion

Chronic rhinosinusitis with nasal polyps has a significant impact on patients’ quality of life. Both functional endoscopic sinus surgery and dupilumab achieve comparable disease control and result in good symptom relief. Dupilumab is far more expensive than functional endoscopic sinus surgery and is not considered cost-effective for the time being. This is expected to change after 10 years when the drug patent expires. More research is needed to compare the complications of both treatment modalities.

Keywords

Nasal polypsendoscopic surgical procedurequality of lifeimmunology
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 4 , April 2024 , pp. 361 - 366
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Asmaa Alshatti takes responsibility for the integrity of the content of the paper

References

Albu, S. Chronic rhinosinusitis--an update on epidemiology, pathogenesis and management. J Clin Med 2020;9:2285CrossRefGoogle Scholar
Cho, SH, Hamilos, DL, Han, DH, Laidlaw, TM. Phenotypes of chronic rhinosinusitis. J Allergy Clin Immunol Pract 2020;8:1505–11CrossRefGoogle ScholarPubMed
Stevens, WW, Schleimer, RP, Kern, RC. Chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol Pract 2016;4:565–72CrossRefGoogle ScholarPubMed
Brescia, G, Zanotti, C, Parrino, D, Barion, U, Marioni, G. Nasal polyposis pathophysiology: endotype and phenotype open issues. Am J Otolaryngol 2018;39:441–4CrossRefGoogle ScholarPubMed
Stevens, WW, Peters, AT, Tan, BK, Klingler, AI, Poposki, JA, Hulse, KE et al. Associations between inflammatory endotypes and clinical presentations in chronic rhinosinusitis. J Allergy Clin Immunol Pract 2019;7:2812–20.e3CrossRefGoogle ScholarPubMed
Chen, CC, Buchheit, KM. Endotyping chronic rhinosinusitis with nasal polyps: understanding inflammation beyond phenotypes. Am J Rhinol Allergy 2023;37:132–9CrossRefGoogle ScholarPubMed
Gevaert, P, Han, JK, Smith, SG, Sousa, AR, Howarth, PH, Yancey, SW et al. The roles of eosinophils and interleukin-5 in the pathophysiology of chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 2022;12:1413–23CrossRefGoogle ScholarPubMed
Simon, HU, Yousefi, S, Schranz, C, Schapowal, A, Bachert, C, Blaser, K. Direct demonstration of delayed eosinophil apoptosis as a mechanism causing tissue eosinophilia. J Immunol 1997;158:3902–8CrossRefGoogle ScholarPubMed
Soman, KV, Stafford, SJ, Pazdrak, K, Wu, Z, Luo, X, White, WI et al. Activation of human peripheral blood eosinophils by cytokines in a comparative time-course proteomic/phosphoproteomic study. J Proteome Res 2017;16:2663–79CrossRefGoogle Scholar
Tomassen, P, Vandeplas, G, Van Zele, T, Cardell, L-O, Arebro, J, Olze, H et al. Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers. J Allergy Clinical Immunol 2016;137:1449–56.e4CrossRefGoogle ScholarPubMed
Doran, E, Cai, F, Holweg, CTJ, Wong, K, Brumm, J, Arron, JR. Interleukin-13 in asthma and other eosinophilic disorders. Front Med (Lausanne) 2017;4:139CrossRefGoogle ScholarPubMed
Kato, A. Immunopathology of chronic rhinosinusitis. Allergol Int 2015;64:121–30CrossRefGoogle ScholarPubMed
Kato, A, Schleimer, RP, Bleier, BS. Mechanisms and pathogenesis of chronic rhinosinusitis. J Allergy Clin Immunol 2022;149:1491–503CrossRefGoogle ScholarPubMed
Hurst, SD, Muchamuel, T, Gorman, DM, Gilbert, JM, Clifford, T, Kwan, S et al. New IL-17 family members promote Th1 or Th2 responses in the lung: in vivo function of the novel cytokine IL-251. J Immunol 2002;169:443–53CrossRefGoogle ScholarPubMed
Lam, M, Hull, L, McLachlan, R, Snidvongs, K, Chin, D, Pratt, E et al. Clinical severity and epithelial endotypes in chronic rhinosinusitis. Int Forum Allergy Rhinol 2013;3:121–8CrossRefGoogle ScholarPubMed
Miljkovic, D, Bassiouni, A, Cooksley, C, Ou, J, Hauben, E, Wormald, P-J et al. Association between group 2 innate lymphoid cells enrichment, nasal polyps and allergy in chronic rhinosinusitis. Allergy 2014;69:1154–61CrossRefGoogle ScholarPubMed
Baba, S, Kondo, K, Kanaya, K, Suzukawa, K, Ushio, M, Urata, S et al. Expression of IL-33 and its receptor ST2 in chronic rhinosinusitis with nasal polyps. Laryngoscope 2014;124:E115–22CrossRefGoogle ScholarPubMed
Yao, Y, Zeng, M, Liu, Z. Revisiting Asian chronic rhinosinusitis in the era of type 2 biologics. Clin Exp Allergy 2022;52:231–43CrossRefGoogle ScholarPubMed
Wang, ET, Zheng, Y, Liu, PF, Guo, LJ. Eosinophilic chronic rhinosinusitis in East Asians. World J Clin Cases 2014;2:873–82CrossRefGoogle ScholarPubMed
ENT UK. Commissioning guide: Chronic Rhinosinusitis, 2016. In: https://www.entuk.org/resources/114/commissioning_guide_for_rhinosinusitis/ [16 May 2023]Google Scholar
Philpott, C, Hopkins, C, Erskine, S, Kumar, N, Robertson, A, Farboud, A et al. The burden of revision sinonasal surgery in the UK--data from the Chronic Rhinosinusitis Epidemiology Study (CRES): a cross-sectional study. BMJ Open 2015;5:e006680CrossRefGoogle ScholarPubMed
Calus, L, Van Bruaene, N, Bosteels, C, Dejonckheere, S, Van Zele, T, Holtappels, G et al. Twelve-year follow-up study after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis. Clin Transl Allergy 2019;9:30CrossRefGoogle ScholarPubMed
Lu, R-M, Hwang, Y-C, Liu, IJ, Lee, C-C, Tsai, H-Z, Li, H-J et al. Development of therapeutic antibodies for the treatment of diseases. J Biomed Sci 2020;27:1CrossRefGoogle ScholarPubMed
Khan, AH, Reaney, M, Guillemin, I, Nelson, L, Qin, S, Kamat, S et al. Development of Sinonasal Outcome Test (SNOT-22) domains in chronic rhinosinusitis with nasal polyps. Laryngoscope 2022;132:933–41CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Glossary. In: https://www.nice.org.uk/glossary?letter=q [10 May 2023]Google Scholar
Miglani, A, Soler, ZM, Smith, TL, Mace, JC, Schlosser, RJ. A comparative analysis of endoscopic sinus surgery versus biologics for treatment of chronic rhinosinusitis with nasal polyposis. Int Forum Allergy Rhinol 2023;13:116–28CrossRefGoogle ScholarPubMed
Scangas, GA, Wu, AW, Ting, JY, Metson, R, Walgama, E, Shrime, MG et al. Cost utility analysis of dupilumab versus endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps. Laryngoscope 2021;131:E26–33CrossRefGoogle ScholarPubMed
Dharmarajan, H, Falade, O, Lee, SE, Wang, EW. Outcomes of dupilumab treatment versus endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 2022;12:986–95CrossRefGoogle ScholarPubMed
Parasher, AK, Gliksman, M, Segarra, D, Lin, T, Rudmik, L, Quast, T. Economic evaluation of dupilumab versus endoscopic sinus surgery for the treatment of chronic rhinosinusitis with nasal polyps. Int Forum Allergy Rhinol 2022;12:813–20CrossRefGoogle ScholarPubMed
Chapurin, N, Khan, S, Gutierrez, J, Soler, ZM. Economics of medical and surgical management of chronic rhinosinusitis with nasal polyps: a contemporary review. Am J Rhinol Allergy 2023;37:227–31CrossRefGoogle ScholarPubMed
van der Lans, RJL, Fokkens, WJ, Adriaensen, GFJPM, Hoven, DR, Drubbel, JJ, Reitsma, S. Real-life observational cohort verifies high efficacy of dupilumab for chronic rhinosinusitis with nasal polyps. Allergy 2022;77:670–4CrossRefGoogle ScholarPubMed
Krings, JG, Kallogjeri, D, Wineland, A, Nepple, KG, Piccirillo, JF, Getz, AE. Complications of primary and revision functional endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope 2014;124:838–45CrossRefGoogle ScholarPubMed
Sanofi. FDA approves Dupixent® (dupilumab) for chronic rhinosinusitis with nasal polyposis. In: https://www.sanofi.com/en/media-room/press-releases/2019/2019-06-26-17-30-00-1874771 [10 May 2023]Google Scholar
Bachert, C, Mannent, L, Naclerio, RM, Mullol, J, Ferguson, BJ, Gevaert, P et al. Effect of subcutaneous dupilumab on nasal polyp burden in patients with chronic sinusitis and nasal polyposis: a randomized clinical trial. JAMA 2016;315:469–79CrossRefGoogle ScholarPubMed
DeConde, AS, Soler, ZM. Chronic rhinosinusitis: epidemiology and burden of disease. Am J Rhinol Allergy 2016;30:134–9CrossRefGoogle ScholarPubMed
Jonas, WB, Crawford, C, Colloca, L, Kaptchuk, TJ, Moseley, B, Miller, FG et al. To what extent are surgery and invasive procedures effective beyond a placebo response? A systematic review with meta-analysis of randomised, sham controlled trials. BMJ Open 2015;5:e009655CrossRefGoogle ScholarPubMed
Wartolowska, K, Judge, A, Hopewell, S, Collins, GS, Dean, BJF, Rombach, I et al. Use of placebo controls in the evaluation of surgery: systematic review. BMJ 2014;348:g3253CrossRefGoogle ScholarPubMed
Mullol, J, Bachert, C, Amin, N, Desrosiers, M, Hellings, PW, Han, JK et al. Olfactory outcomes with dupilumab in chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol Pract 2022;10:1086–95.e5CrossRefGoogle ScholarPubMed
Tameez Ud Din, A, Malik, I, Arshad, D, Tameez Ud Din, A. Dupilumab for atopic dermatitis: the silver bullet we have been searching for? Cureus 2020;12:e7565Google ScholarPubMed
Bachert, C, Han, JK, Desrosiers, M, Hellings, PW, Amin, N, Lee, SE et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet 2019;394:1638–50CrossRefGoogle ScholarPubMed
Rudmik, L, Drummond, M. Health economic evaluation: important principles and methodology. Laryngoscope 2013;123:1341–7CrossRefGoogle ScholarPubMed
Intellectual Property Office. Supplementary Protection Certificate Search. In: https://www.ipo.gov.uk/p-find-spc.htm [19 May 2023]Google Scholar
Government of Canada. Voluntary Compliance Undertaking of Sanofi-Aventis Canada Inc. to the Patented Medicine Prices Review Board. In: https://www.pmprb-cepmb.gc.ca/view.asp?ccid=1459&lang=en [19 May 2023]Google Scholar