Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (3): 36-42.doi: 10.6040/j.issn.1673-3770.0.2021.565

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Research advances of dupilumab in the treatment of chronic rhinosinusitis with nasal polyps

SHI Shuai1, ZHENG Quan1Overview,CHENG Lei2   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian 223800, Jiangsu, China;
    2. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Published:2022-06-15

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Abstract: Chronic rhinosinusitis(CRS)is a common inflammatory disease of the paranasal sinus mucosa. Complex mechanisms lead to a strongly heterogeneous CRS, and some patients do not find relief using the current standard drug treatment and surgery. CRS has different inflammatory endotypes and clinical phenotypes; CRS with nasal polyps(CRSwNP)has always been difficult to treat, as its symptoms are relatively severe and often complicated by asthma. It is often unresponsive to conventional drugs and surgery and has a high risk of reoccurring. In recent years, dupilumab has been found to be effective in adult intractable CRSwNP by blocking the signal transduction of interleukin(IL)-4 and IL-13, which are the key driving factors in type II inflammation. Currently, the study of dupilumab in the treatment of CRSwNP in China has not been reported. This article reviews the progress achieved in the research of dupilumab in the treatment of CRSwNP, to provide a reference for its further application and research in treating CRSwNP.

Key words: Chronic rhinosinusitis with nasal polyps, Biologics, Dupilumab, Type II inflammation, IL-4Rα

CLC Number: 

  • R765.41
[1] Dietz de Loos D, Lourijsen ES, Wildeman MAM, et al. Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology[J]. The Journal of Allergy and Clinical Immunology, 2019, 143(3): 1207-1214. doi: 10.1016/j.jaci.2018.12.986.
[2] Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020[J]. Rhinology, 2020, 58(Suppl S29): 1-464. doi:10.4193/Rhin20.600.
[3] Orlandi RR, Kingdom TT, Smith TL, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021[J]. Int Forum Allergy Rhinol, 2021, 11(3): 213-739. doi:10.1002/alr.22741.
[4] Shi JB, Fu QL, Zhang H, et al. Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities[J]. Allergy, 2015, 70(5): 533-539. doi:10.1111/all.12577.
[5] MacDonald KI, McNally JD, Massoud E. The health and resource utilization of Canadians with chronic rhinosinusitis[J]. Laryngoscope, 2009, 119(1): 184-189. doi:10.1002/lary.20034.
[6] de Benedictis FM, Bush A. Janus looks both ways: how do the upper and lower airways interact? [J]. Paediatr Respir Rev, 2020, 34: 59-66. doi:10.1016/j.prrv.2019.06.004.
[7] Kariyawasam HH, Rotiroti G. Allergic rhinitis, chronic rhinosinusitis and asthma: unravelling a complex relationship[J]. Curr Opin Otolaryngol Head Neck Surg, 2013, 21(1): 79-86. doi:10.1097/MOO.0b013e32835ac640.
[8] 王成硕, 张罗. 慢性鼻窦炎伴鼻息肉进入生物制剂治疗时代[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(10): 1023-1027. doi:10.3760/cma.j.cn115330-20210509-00260. WANG Chengshuo, ZHANG Luo. Biologics: a new option in treatment of chronic rhinosinusitis with nasal polyps[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2021, 56(10): 1023-1027. doi:10.3760/cma.j.cn115330-20210509-00260.
[9] Kariyawasam HH. Chronic rhinosinusitis with nasal polyps: mechanistic insights from targeting IL-4 and IL-13 via IL-4Rα inhibition with dupilumab[J]. Expert Rev Clin Immunol, 2020, 16(12): 1115-1125. doi:10.1080/1744666X.2021.1847083.
[10] Bachert C, Han JK, Desrosiers M, 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[J]. Lancet, 2019, 394(10209): 1638-1650. doi:10.1016/S0140-6736(19)31881-1.
[11] Wang XD, Zhang N, Bo MY, et al. Diversity of TH cytokine profiles in patients with chronic rhinosinusitis: a multicenter study in Europe, Asia, and Oceania[J]. J Allergy Clin Immunol, 2016, 138(5): 1344-1353. doi:10.1016/j.jaci.2016.05.041.
[12] Kim DW, Cho SH. Emerging endotypes of chronic rhinosinusitis and its application to precision medicine[J]. Allergy Asthma Immunol Res, 2017, 9(4): 299-306. doi:10.4168/aair.2017.9.4.299.
[13] Katotomichelakis M, Tantilipikorn P, Holtappels G, et al. Inflammatory patterns in upper airway disease in the same geographical area may change over time[J]. Am J Rhinol Allergy, 2013, 27(5): 354-360. doi:10.2500/ajra.2013.27.3922.
[14] Kim SJ, Lee KH, Kim SW, et al. Changes in histological features of nasal polyps in a Korean population over a 17-year period[J]. Otolaryngol Head Neck Surg, 2013, 149(3): 431-437. doi:10.1177/0194599813495363.
[15] Zhang Y, Gevaert E, Lou HF, et al. Chronic rhinosinusitis in Asia[J]. J Allergy Clin Immunol, 2017, 140(5): 1230-1239. doi:10.1016/j.jaci.2017.09.009.
[16] McCormick SM, Heller NM. Commentary: IL-4 and IL-13 receptors and signaling[J]. Cytokine, 2015, 75(1): 38-50. doi:10.1016/j.cyto.2015.05.023.
[17] Lupardus PJ, Birnbaum ME, Garcia KC. Molecular basis for shared cytokine recognition revealed in the structure of an unusually high affinity complex between IL-13 and IL-13Ralpha2[J]. Structure, 2010, 18(3): 332-342. doi:10.1016/j.str.2010.01.003.
[18] Ouyang W, Löhning M, Gao Z, et al. Stat6-independent GATA-3 autoactivation directs IL-4-independent Th2 development and commitment[J]. Immunity, 2000, 12(1): 27-37. doi:10.1016/s1074-7613(00)80156-9.
[19] Annunziato F, Romagnani C, Romagnani S. The 3 major types of innate and adaptive cell-mediated effector immunity[J]. J Allergy Clin Immunol, 2015, 135(3): 626-635. doi:10.1016/j.jaci.2014.11.001.
[20] Wills-Karp M. IL-12/IL-13 axis in allergic asthma[J]. J Allergy Clin Immunol, 2001, 107(1): 9-18. doi:10.1067/mai.2001.112265.
[21] Jonstam K, Swanson BN, Mannent LP, et al. Dupilumab reduces local type 2 pro-inflammatory biomarkers in chronic rhinosinusitis with nasal polyposis[J]. Allergy, 2019, 74(4): 743-752. doi:10.1111/all.13685.
[22] 李华斌, 赖玉婷. 慢性鼻-鼻窦炎的发病机制及诊疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 4-9. doi: 10.6040/j.issn.1673-3770.1.2018.004. LI Huabin, LAI Yuting. Pathogenesis, diagnosis, and treatment of chronic rhinosinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(3): 4-9. doi: 10.6040/j.issn.1673-3770.1.2018.004.
[23] Desrosiers M, Mannent LP, Amin N, et al. Dupilumab reduces systemic corticosteroid use and sinonasal surgery rate in CRSwNP[J]. Rhinology, 2021, 59(3): 301-311. doi:10.4193/Rhin20.415.
[24] Geng B, Bachert C, Busse WW, et al. Respiratory infections and anti-infective medication use from phase 3 dupilumab respiratory studies[J]. J Allergy Clin Immunol Pract, 2022, 10(3): 732-741. doi:10.1016/j.jaip.2021.12.006.
[25] Myung JH, Seo HJ, Park SJ, et al. Association of nasal inflammation and lower airway responsiveness in schoolchildren based on an epidemiological survey[J]. Korean J Intern Med, 2015, 30(2): 226. doi:10.3904/kjim.2015.30.2.226.
[26] Uraguchi K, Kariya S, Makihara S, et al. Pulmonary function in patients with eosinophilic chronic rhinosinusitis[J]. Auris Nasus Larynx, 2018, 45(3): 476-481. doi:10.1016/j.anl.2017.07.020.
[27] Ricciardolo FLM, Levra S, Sprio AE, et al. A real-world assessment of asthma with chronic rhinosinusitis[J]. Ann Allergy Asthma Immunol, 2020, 125(1): 65-71. doi:10.1016/j.anai.2020.03.004.
[28] Langdon C, Mullol J. Nasal polyps in patients with asthma: prevalence, impact, and management challenges[J]. J Asthma Allergy, 2016, 9: 45-53. doi:10.2147/JAA.S86251.
[29] Promsopa C, Kansara S, Citardi MJ, et al. Prevalence of confirmed asthma varies in chronic rhinosinusitis subtypes[J]. Int Forum Allergy Rhinol, 2016, 6(4): 373-377. doi:10.1002/alr.21674.
[30] Laidlaw TM, Bachert C, Amin N, et al. Dupilumab improves upper and lower airway disease control in chronic rhinosinusitis with nasal polyps and asthma[J]. Ann Allergy Asthma Immunol, 2021, 126(5): 584-592.e1. doi:10.1016/j.anai.2021.01.012.
[31] Rajan JP, Wineinger NE, Stevenson DD, et al. Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: a meta-analysis of the literature[J]. J Allergy Clin Immunol, 2015, 135(3): 676-681.e1. doi:10.1016/j.jaci.2014.08.020.
[32] White AA, Doherty TA. Role of group 2 innate lymphocytes in aspirin-exacerbated respiratory disease pathogenesis[J]. Am J Rhinol Allergy, 2018, 32(1): 7-11. doi:10.2500/ajra.2018.32.4498.
[33] Steinke JW, Payne SC, Borish L. Eosinophils and mast cells in aspirin-exacerbated respiratory disease[J]. Immunol Allergy Clin North Am, 2016, 36(4): 719-734. doi:10.1016/j.iac.2016.06.008.
[34] Kowalski ML, Agache I, Bavbek S, et al. Diagnosis and management of NSAID-Exacerbated Respiratory Disease(N-ERD)-a EAACI position paper[J]. Allergy, 2019, 74(1): 28-39. doi:10.1111/all.13599.
[35] Mullol J, Laidlaw TM, Bachert C, et al. Efficacy and safety of dupilumab in patients with uncontrolled severe chronic rhinosinusitis with nasal polyps and a clinical diagnosis of NSAID-ERD: results from two randomized placebo-controlled phase 3 trials[J]. Allergy, 2022, 77(4): 1231-1244. doi:10.1111/all.15067.
[36] Fujieda S, Matsune S, Takeno S, et al. The effect of dupilumab on intractable chronic rhinosinusitis with nasal polyps in Japan[J]. Laryngoscope, 2021, 131(6): E1770-E1777. doi:10.1002/lary.29230.
[37] Tokunaga T, Sakashita M, Haruna T, et al. Novel scoring system and algorithm for classifying chronic rhinosinusitis: the JESREC Study[J]. Allergy, 2015, 70(8): 995-1003. doi:10.1111/all.12644.
[38] Fujieda S, Matsune S, Takeno S, et al. Dupilumab efficacy in chronic rhinosinusitis with nasal polyps from SINUS-52 is unaffected by eosinophilic status[J]. Allergy, 2022, 77(1): 186-196. doi:10.1111/all.14906.
[39] Bachert C, Hellings PW, Mullol J, et al. Dupilumab improves health-related quality of life in patients with chronic rhinosinusitis with nasal polyposis[J]. Allergy, 2020, 75(1): 148-157. doi:10.1111/all.13984.
[40] Gevaert P, Omachi TA, Corren J, et al. Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials[J]. J Allergy Clin Immunol, 2020, 146(3): 595-605. doi:10.1016/j.jaci.2020.05.032.
[41] Han JK, Bachert C, Fokkens W, et al. Mepolizumab for chronic rhinosinusitis with nasal polyps(SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet Respir Med, 2021, 9(10): 1141-1153. doi:10.1016/S2213-2600(21)00097-7.
[42] Peters AT, Han JK, Hellings P, et al. Indirect treatment comparison of biologics in chronic rhinosinusitis with nasal polyps[J]. J Allergy Clin Immunol Pract, 2021, 9(6): 2461-2471.e5. doi:10.1016/j.jaip.2021.01.031.
[43] Mümmler C, Dünzelmann K, Kneidinger N, et al. Real-life effectiveness of biological therapies on symptoms in severe asthma with comorbid CRSwNP[J]. Clin Transl Allergy, 2021, 11(5): e12049. doi:10.1002/clt2.12049.
[44] Wu QW, Zhang YN, Kong WF, et al. Which is the best biologic for nasal polyps: dupilumab, omalizumab, or mepolizumab? A network meta-analysis[J]. Int Arch Allergy Immunol, 2022, 183(3): 279-288. doi:10.1159/000519228.
[45] Bachert C, Sousa AR, Lund VJ, et al. Reduced need for surgery in severe nasal polyposis with mepolizumab: Randomized trial[J]. J Allergy Clin Immunol, 2017, 140(4): 1024-1031.e14. doi:10.1016/j.jaci.2017.05.044.
[46] Brown WC, Senior B. A critical look at the efficacy and costs of biologic therapy for chronic rhinosinusitis with nasal polyposis[J]. Curr Allergy Asthma Rep, 2020, 20(6): 1-6. doi:10.1007/s11882-020-00910-y.
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