Abstract
Objective: To evaluate the clinical effect of omalizumab therapy on the symptoms of patients with chronic rhinosinusitis (CRS). Methods: This cross-sectional study evaluated CRS major symptom improvement in patients with CRS on omalizumab therapy and patients who met omalizumab therapy indications, but could not access coverage for omalizumab. Changes in overall chronic rhinosinusitis symptom burden and each of the major symptoms of CRS were rated on a 10 cm visual analogue scale (VAS). The Mann–Whitney test was used to compare the symptom improvement between groups. Results: Omalizumab therapy provided a mean overall symptom improvement of 69.5% (individual symptom improvement: facial pain 78.5%, nasal obstruction 69.8%, rhinorrhea 56.2%, and olfaction 55.8%). For the control group, mean overall symptom improvement since omalizumab screening was 16.8% (individual symptom improvement: rhinorrhea 16.4%, nasal obstruction 15.3%, no improvement in facial pain or olfaction). Overall, and for each major symptom, improvement was significantly greater for omalizumab treated patients (p < 0.05). Conclusion: Omalizumab treatment provided significant improvement in every major clinical symptom of CRS in the treated cohort of patients with recalcitrant CRS, in comparison to the control cohort. A well-designed randomized clinical trial is needed to further assess the efficacy and safety of omalizumab treatment for CRS.
Highlights
Chronic rhinosinusitis (CRS) is a disease of considerable prevalence, affecting 2–16% of the population in the United States and Canada [1,2]
Omalizumab therapy provided a mean overall chronic rhinosinusitis symptom burden improvement of 69.5%
This real-world study found that patients with severe CRS with asthma reported significant improvement in all of their sinonasal symptomatology after being treated with omalizumab monoclonal. This real-world study found that patients with severe CRS with asthma reported significant antibody therapy. These results are consistent with a similar retrospective study, in which twenty-eight improvement in all of their sinonasal symptomatology after being treated with omalizumab out of 37 patients reported improvement in their CRS symptoms, and 22 out of 37 patients reported a monoclonal antibody therapy
Summary
Chronic rhinosinusitis (CRS) is a disease of considerable prevalence, affecting 2–16% of the population in the United States and Canada [1,2]. CRS is a complex inflammatory disease characterized by persistent inflammation of the paranasal sinuses, with concomitant bacterial colonization [3,4,5,6,7,8]. The symptoms of this disease negatively affect the physical and psychological wellbeing of patients, thereby decreasing their overall quality of life [3]. Therapies range from medical therapies, including saline irrigations, intranasal corticosteroids and antibiotics, to surgical intervention, primarily endoscopic sinus surgery These therapies focus on symptom control, and historically effective for symptom relief and inflammatory reduction, they do not target specific underlying disease pathophysiology.
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