Improvement In Nasal Symptoms Research Articles

Efficacy of Biologic Therapies in the Management of Allergic Rhinitis: A Systematic Review.

Allergic rhinitis (AR) is a common chronic condition characterized by nasal congestion, sneezing, and itching, which significantly impacts quality of life. Traditional treatments, including antihistamines and intranasal corticosteroids, often fall short in managing moderate-to-severe cases. Recently, biologic therapies such as omalizumab and dupilumab have emerged as potential alternatives. This systematic review aims to evaluate the efficacy and safety of these biologic therapies in the management of AR. A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, and Web of Science to identify studies published between 2000 and 2024. Studies included were randomized controlled trials, cohort studies, and post-hoc analyses that assessed the impact of biologics on AR symptoms. Data on study characteristics, population demographics, intervention details, and outcomes were extracted and analyzed. The review included nine studies evaluating omalizumab and dupilumab. Omalizumab demonstrated significant improvements in nasal symptoms and quality of life, with notable efficacy in reducing symptoms and improving asthma control in patients with moderate-to-severe AR. Dupilumab also showed positive outcomes, particularly in patients with comorbid asthma and perennial AR, by reducing severe exacerbations and improving symptom scores. Biologic therapies, including omalizumab and dupilumab, offer promising alternatives for the management of AR, especially in cases that are severe or refractory to conventional treatments. The evidence supports their efficacy in improving symptoms and quality of life. Nevertheless, further research is required to address the limitations identified, including the need for long-term data and clarification of the mechanisms of action. These findings underscore the potential of biologics in advancing the treatment of AR and highlight the importance of ongoing research to optimize patient outcomes.

Reply to Letter Regarding "Improvement in Nasal Symptoms of Chronic Rhinitis After Cryoablation of the Posterior Nasal Nerve".

Reply to Letter Regarding "Improvement in Nasal Symptoms of Chronic Rhinitis After Cryoablation of the Posterior Nasal Nerve".

Comparison between clinical and cytological findings in chronic rhinosinusitis with nasal polyps treated with Dupilumab.

Biologics represent a new therapeutic strategy for severe and recurrent chronic rhinosinusitis with nasal polyps (CRSwNP). Usually, their actual therapeutic effectiveness is assessed by reduction in nasal polyps and/or improvement in nasal symptoms and quality of life. However, these measures do not consider nasal immunophlogosis, which can be evaluated through nasal cytology. The purpose of this study was to assess not only the clinical impact but also the cellular changes in the nasal inflammatory infiltrate observed through nasal cytology of CRSwNP patients treated with Dupilumab for 24 months. Fifty-five CRSwNP patients treated with Dupilumab were collected. Patients were evaluated before starting treatment and at one, three, six, nine months, one year, one and a half years, and two years after the first drug administration. During follow-up visits patients underwent endoscopic evaluation, nasal symptoms and quality of life assessment, complete blood count and nasal cytology. During follow-up, significant improvement was found in Nasal Polyps Score (NPS), nasal patency, olfaction, Sino-Nasal Outcome Test (SNOT-22) score, and Visual Analogue Scale (VAS). Regarding nasal cytology, a reduction in eosinophils and mast cells in the cellular infiltrate was observed over the two-year follow-up period compared to baseline. Dupilumab has demonstrated broad efficacy in the management of CRSwNP from both clinical and cytological findings. Further studies are needed to confirm our findings and evaluate the biologics' impact on nasal mucosal inflammatory cells by nasal cytology with the aim of better identifying each patient's endotype and predicting the response to biologics.

Use of bovine-derived collagen matrix in the surgical treatment of empty nose syndrome.

Bovine-derived collagen matrix (BDCM) is a safe augmentation material in patients with empty nose syndrome. BDCM augmentation results in clinically and statistically significant improvement in nasal symptoms. Improvements in nasal symptoms with BDCM augmentation may be durable and can be seen up to 2 years postoperative.

A Comparative Study of Outcomes of Submucosal Diathermy Versus Inferior Turbinoplasty in Patients With Deviated Nasal Septum With Inferior Turbinate Hypertrophy.

Introduction Nasal obstruction due to deviated nasal septum (DNS) and inferior turbinate hypertrophy (ITH) is a common problem necessitating surgical intervention. Submucosal diathermy (SMD) and inferior turbinoplasty (IT) are two commonly performed procedures aimed at improving nasal patency. Methods A prospective comparative study was conducted on 56 patients with DNS and inferior turbinate hypertrophy, divided into SMD and inferior turbinoplasty groups. Preoperative and postoperative assessments included symptom assessment using the 22-itemSinonasalOutcomeTest(SNOT-22) questionnaire. Results Both procedures led to significant improvements in nasal symptoms and quality of life. Inferior turbinoplasty showed slightly better outcomes in symptom improvement compared to submucosal diathermy. Conclusions Inferior turbinoplasty appears to offer slightly better outcomes in improving nasal symptoms compared to SMD in patients with DNS and inferior turbinate hypertrophy. However, both procedures are effective and safe options for surgical management. Individualized treatment decisions should consider patient preferences and surgeon expertise.

The benefit and clinical value of CT scan as preoperative assessment for structural functional septorhinoplasty

<b>Introduction:</b> Structural functional septorhinolplasty is an operation designed to achieve both aesthetic and functionalgoals, which were the most important success parameters for patient satisfaction. Different preoperative examination toolsare available for assessment.<b>Aim:</b> To evaluate the diagnostic benefit and clinical value of a CT scan, and compare it with other examination tools, such as nasal endoscopy and anterior rhinoscopy for structural functional septorhinoplasty<b>Material and Methods:</b> A prospective randomized controlled study of 148 consecutive patients seeking for a solution to their primary problem of nasal obstruction, and also for a cosmetic effect within the same operation (structural functional septorhinoplaty). They were divided into 3 groups; CT scan group, endoscopic group, and control group (anterior rhinoscopy). The subjective postoperative assessment was carried out with the Nasal Obstruction Symptom Evaluation scale (NOSE), Rhinoplasty Outcome Evaluation scale (ROE), Visual Analogue Scale (VAS), and SNOT-22 score. Those outcomes at 12-month follow-up were compared to preoperative values.<b>Results:</b> Among 148 patients, there were 77 males (52.02%) and 71 females (47.97%), age range between 19 to 52 years (mean age 23.4 2.7 SD). In all 3 groups, there was a significant clinical improvement in nasal symptoms and structural functional septorhinoplasty outcomes, as well as better ROE, NOSE, VAS, and SNOT-22 scores in the CT scan group when compared to the other two groups, with the P-values being 0.01, 0.01, 0.03, and 0.04, respectively.<b>Conclusions:</b>CT scan is of greater benefit than nasal endoscopy and anterior rhinoscopy and constitutes the method of choice as a part of preoperative assessment in detecting any nasal pathology and assessing nasal anatomical structures prior to structural functional septorhinoplasty.

A systematic review of randomised controlled trials on topical nasal steroids.

Intranasal corticosteroids (INCs) are the first line of therapy for chronic sinonasal conditions such as rhinitis and rhinosinusitis. Among these, one of the most frequently used is beclomethasone dipropionate (BDP). Over the years many studies have evaluated the efficacy of BDP as part of therapy for chronic rhinosinusitis (CRS) and allergic rhinitis (AR) along with nasal washes, which seems to be very well tolerated. To analyse the data in the literature regarding the various therapeutic regimens of BDP in different sinonasal disease and their efficacy and tolerability. Using different search engines, the posology, efficacy, and tolerability of BDP were reviewed and a total of 64 full-length articles were examined for eligibility. After applying inclusion and exclusion criteria, 4 articles were reviewed. BDP is among the group of INCs with significant improvement of nasal symptoms and has good efficacy and safety. BDP nasal spray is one of the most frequently prescribed INC for rhinitis and rhinosinusitis. Treatment with BDP resulted in significant and clinically meaningful improvements in nasal symptoms associated with AR and CRS. BDP is well tolerated, and the safety profile is similar to that of placebo in most patients. These results, in conjunction with the significant benefit reported in subjects with CRS and AR, provide convincing evidence of the overall effectiveness of BDP for the treatment of the full spectrum of sinonasal disease.

Letter Regarding "Improvement in Nasal Symptoms of Chronic Rhinitis after Cryoablation of the Posterior Nasal Nerve":Towarda Unified Airway Approach.

Letter Regarding "Improvement in Nasal Symptoms of Chronic Rhinitis after Cryoablation of the Posterior Nasal Nerve":Towarda Unified Airway Approach.

Ефективність та безпечність інтраназального застосування фіксованої комбінації олопатадину гідрохлориду та мометазону фуроату в терапії пацієнтів з алергічним ринітом

Abstract. One of the options for pharmacotherapy of allergic rhinitis (AR) with values of visual analogue assessment of symptoms ≥ 5 is the use of intranasal H1-histamine blocker in combination with intranasal cocorticosteroid. One of the new combinations that qualitatively corresponds to this composition is the combination of olopatadine hydrochloride and mometasone furoate. The aim of the study was to study the effectiveness and safety of symptomatic therapy by the fixed combination of olopatadine hydrochloride and mometasone furoate in the form of a nasal spray in the treatment of AR. Materials and methods. 45 patients were examined, of which 37 patients completed treatment (8 patients dropped out of the study due to poor compliance). All of them made up the main group of the study (age — 29.3 (16.6; 42.0) years, men — 13 (35.0 %), women — 24 (65.0 %). The design of the study was randomized prospective with interventional model in the form of monoprescription. The diagnosis of AR was established in accordance with the ARIA guidelines. To control nasal symptoms before and during treatment, a generally accepted scoring system was used — the TNSS scale (Total nasal symptom score), eye symptoms — the TOSS scale (Total ocular symptom score) The Rhinoconjunctivitis Quality of Life mini Questionnaire (RQLQ) was used to assess the quality of life of AR patients. The results. In the course of treatment, a statistically significant improvement in nasal symptoms (TNSS) was noted — a decrease in severity from 10.11 (8.71; 11.51) points to 1.31 (1.00; 1.63) points on the 28-th day of treatment (p < 0.05). A similar statistically significant improvement was observed in the severity of ocular symptoms (TOSS) — a decrease in severity from 3.31 (1.81, 4.81) points to 0.36 (0.30, 0.42) points on the 28-th day of treatment (p < 0.05). A statistically significant improvement in the quality of life according to the RQLQ during treatment was noted — the score decreased from 3.04 (2.72; 3.37) points at the initial visit to 1.83 (1.61; 2.05) points on the 7-th day. 1.02 (0.86, 1.18) points on day 14, 0.63 (0.51, 0.75) points on day 21 and 0.45 (0.41, 0.49) points on day 28 treatment (p < 0.05). Conclusion. A fixed combination of mometasone furoate and olopatadine hydrochloride was effective in relieving nasal and ocular symptoms in patients with moderate/severe AR, reducing the TONSS score from 13.42 (10.81; 16.03) to 1.67 (1.14; 2.20) points and in improving the quality of life, reducing the degree of discomfort from 3.04 (2.72; 3.37) points to 0.45 (0.41; 0.49) points. For 4 weeks of use, no side effects from the use of the drug were registered, which indicates good tolerability.

Improvement in Nasal Symptoms of Chronic Rhinitis after Cryoablation of the Posterior Nasal Nerve.

To determine the efficacy of posterior nasal nerve (PNN) cryoablation for improving the symptoms of chronic rhinitis. Retrospective cohort study. A private practice. This study evaluated medication usage and adverse effects of in-office PNN cryoablation with a handheld device in patients > 18 years with chronic (>6 months) allergic or nonallergic rhinitis for whom medical management failed. The total nasal symptom score (TNSS) and mini rhinoconjunctivitis quality of life questionnaire (mRQLQ) scores were compared before and after treatment. This study included 127 patients with a mean age of 52.4 ± 16.9 years; 60.6% of patients were female and 49.6% had allergic rhinitis. Mean symptom scores decreased from 5.94 (95% confidence interval [CI], 5.51-6.43) to 3.44 (95% CI, 2.97-3.81, P < .001) after the procedure, with clinically important decreases in 75 (59.1%) patients. For patients with baseline TNSS values of ≥4, 63.5% (66/104) had a clinically important decrease, whereas only 39.1% (9/23) of those with the lower baseline did (P = .04). Mean mRQLQ scores also decreased from 2.51 (95% CI, 2.29-2.72) to 1.28 (95% CI, 1.20-1.47, P < .001) after the procedure. Seventy-eight of 273 (28.6%) medications were discontinued after the procedure. Adverse effects occurred in 18.1% (23/127) of patients with headache as the most common. PNNcryoablation improves nasal symptoms and quality of life in patients with chronic rhinitis. Patients with a higher baseline TNSS are more likely to experience significant symptomatic improvement.

A Comparison of Symptom Improvement and Outcomes After Septoplasty Alone Versus Septoplasty With Turbinoplasty.

Background Various causes can lead to nasal obstruction, with the most frequent anatomical cause being deviated nasal septum. It seriously affects patients' quality of life. As a result, septoplasty is performed to enhance the nasal airways. This study aimed to compare the improvement of nasal symptoms following septoplasty with or without turbinoplasty and evaluate the surgical outcomes in both different groups. Methodology A retrospective study was conducted at a tertiary hospital among patients who had undergone septoplasty with or without turbinoplasty between 2020 and 2022. Data regarding demographics, clinical features, surgical data, and complications were collected from patient files. The Nasal Obstruction Symptom Evaluation (NOSE) scale score was assessed through structured interviews. Results In our analysis of 209 patients who underwent surgery for deviated nasal septum, septoplasty was done in 110 (52.6%) patients, whereas the remaining 99 (47.4%) underwent septoplasty with turbinoplasty. The mean NOSE score was found to be 32.94 ± 35.67%. Patients who underwent septoplasty alone significantly showed higher mean scores (56.36 ± 34.62%) compared to those who underwent septoplasty with turbinoplasty (11.14 ± 18.93%) (p < 0.001). The long-term complications showed revision surgery was done in 13 patients, which was comparatively more often done in patients who underwent a septoplasty. Other long-term complications were found to be significantly higher in patients who underwent septoplasty (76.9%) compared to those who underwent septoplasty with turbinoplasty (23.1%). Conclusions Patients who underwent additional turbinoplasty experienced an improvement in nasal symptoms than those who underwent septoplasty alone. In addition, more long-term complications were noted in patients who underwentseptoplasty alone.

Long-term efficacy of HDM-SCIT in pediatric and adult patients with allergic rhinitis

BackgroundSubcutaneous immunotherapy (SCIT) is a well-validated and effective disease modification treatment for house dust mites (HDM)-induced allergic rhinitis (AR). Long-term post-treatment comparisons in children and adults treated with SCIT have rarely been published. This study aimed to evaluate the long-term efficacy of HDM-SCIT administered under a cluster schedule in children compared to adults.MethodsThis was an open-design, observational, long-term clinical follow-up study on children and adults with perennial AR treated with HDM-SCIT. The follow-up consisted of a three-year treatment duration plus a post-treatment follow-up of over three years.ResultsPatients in the pediatric (n = 58) and adult (n = 103) groups completed a post-SCIT follow-up of over three years. The total nasal symptom score (TNSS), combined symptom medication score (CSMS), and rhinoconjunctivitis quality-of-life questionnaire (RQLQ) score decreased significantly at T1 (three-year SCIT completed) and T2 (follow-up completed) in the pediatric and adult groups. In both groups, the improvement rate of TNSS (T0-T1) was moderately correlated with the baseline TNSS (r = 0.681, p < 0.001 and r = 0.477, p < 0.001 for children and adults, respectively). Only in the pediatric group, TNSS was significantly lower at T2 compared with that right after SCIT cessation (T1) (p = 0.030).ConclusionsChildren and adults with HDM-induced perennial AR could achieve a sustainable post-treatment efficacy for over three years (up to 13 years) following a three-year SCIT. Patients with relatively severe nasal symptoms at baseline may benefit more from SCIT. Children who have completed an adequate course of SCIT may gain further improvement in nasal symptoms after SCIT cessation.

The role of large cavity sinus surgery in the management of chronic rhinosinusitis in N-ERD: a single-centre experience and long-term outcomes.

This study aimed to discuss the role of large cavity functional endoscopic sinus surgery in the management of chronic rhinosinusitis with nasal polyps in patients with non-steroidal anti-inflammatory drug exacerbated respiratory disease. This was a retrospective review of patients undergoing large cavity functional endoscopic sinus surgery for non-steroidal anti-inflammatory drug exacerbated respiratory disease from January 2016 to March 2022. Population characteristics, pre- and post-operative number of functional endoscopic sinus surgical procedures, endoscopic polyp grade, Lund-Mackay score and nasal symptoms were recorded. Thirteen consecutive patients with a median age of 47 years were included. They all failed maximal medical treatment and/or conservative functional endoscopic sinus surgery and underwent large cavity sinus surgery followed by post-operative maximal medical therapy. All patients showed an improvement in nasal symptoms with improved Lund-Mackay scores post-operatively. The median length of follow up was 1.5 years. Large cavity functional endoscopic sinus surgery seems to halt the progression of chronic rhinosinusitis with nasal polyps in non-steroidal anti-inflammatory drug exacerbated respiratory disease. In this case series, large cavity functional endoscopic sinus surgery combined with optimal post-operative medical treatment appeared to switch off chronic rhinosinusitis with nasal polyps in patients with non-steroidal anti-inflammatory drug exacerbated respiratory disease.

Validity of Sinonasal Outcome Test 22 in Assessing Symptomatological Outcome Following Septoplasty in Deviated Nasal Septum

Introduction: Nasal obstruction is the most common symptom of deviated nasal septum. Septoplasty is a surgical procedure that corrects deformity of the nasal septum. Sinonasal outcome test 22 is a subjective questionnaire tool that include various nasal symptoms which is useful to measure patient`s symptoms outcome after septoplasty.&#x0D; Aims: To determine the symptomatologic outcome in patients with deviated nasal septum following septoplasty using Sinonasal outcome test 22.&#x0D; Methods: This prospective longitudinal study was done atNepalgunj Medical College and Teaching Hospital, Kohalpur including 60 patients of symptomatic deviated nasal septum who underwent septoplasty. Details of patient symptoms as per Sinonasal outcome test - 22 were graded from zero to five preoperatively and were compared one month following surgery.&#x0D; Results: Patients who underwent septoplasty were commonly in the age group 20-45 years and least in the age group 46-60 years with a mean age of 25.48. In the present study, the male to female ratio was 1.4:1. Deviated nasal septum was more common on the left side (53.3%). The mean preoperative sinonasal outcome test -22 score was 24.42 (range 14-40), and the mean postoperative sinonasal outcome test-22 score was 12.93 (range 8-23) and the difference was 11.49.&#x0D; Conclusion: Sinonasal outcome test 22 is a subjective questionnaire tool used in patients with deviated nasal septum. In our study with the use of this questionnaire tool there was improvement in nasal symptoms on comparing preoperative and postoperative symptoms following septoplasty.

A comparative study of efficacy and outcomes of endoscopic versus conventional technique in septoturbinoplasty

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Septal deviation is a very common clinical entity which often affects nasal aesthetics and functionality requiring surgical correction. With the advent of rigid endoscopy, newer techniques of endoscopic surgery have come into place that are replacing conventional methods. The aim of the study was to compare the two septoturbinoplasty procedures (endoscopic and conventional) using both objective and subjective data and thereby determine the advantages an endoscope provides during nasal septal surgery.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; It is a prospective comparative study of 56 patients out of which 28 patients underwent endoscopic septoturbinoplasty and the remaining 28 underwent conventional septoturbinoplasty. Outcomes measured were improvement of nasal symptoms following the surgery based on subjective questionnaire data collected, operation time and post-operative complications. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean NOSE questionnaire scores pre-operatively were 67.32±12.4 for the conventional group and 64.64±14.9 for the endoscopic group. The post-operative scores were 6.43±7.2 for the conventional group and 4.64±6.8 for the endoscopic group. Similarly, the operative time as well as the rate of post-operative complications were lesser in the endoscopic technique compared to the conventional technique.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Both conventional and endoscopic techniques are effective in correcting the septal deviation as proved by significant subjective improvement in patient symptom scores post-surgery. The use of an endoscope, on the other hand, results in a shorter operation time and a lower complication rate after surgery.&lt;/p&gt;

Impact of Preventive Measures on Subjective Symptoms and Antigen Sensitization against Japanese Cedar, Cypress Pollen and House Dust Mites in Patients with Allergic Rhinitis: A Retrospective Analysis in the COVID-19 Era

For &gt;2 years, Japan’s government has been urging the populace to take countermeasures to prevent COVID-19, including mask wearing. We examined whether these preventive behaviors have affected the rate and degree of sensitization against pollen and house dust antigens in patients with allergic rhinitis. We retrospectively surveyed 2565 patients who had undergone allergy blood testing during the period 2015–2021. We subdivided this period into eras based on the COVID-19 pandemic: the pre-COVID (2015–2019, n = 1879) and COVID (2020–2021, n = 686) eras. The positive rates for Japanese cedar and cypress in the 40–59-year-olds and those for house dust in the 20–39-year-olds were significantly reduced in the COVID era versus those in the pre-COVID era. Each group’s mean antigen-specific CAP scores decreased significantly from the 1st to 2nd era: from 1.98 to 1.57 for cedar (p &lt; 0.01), 1.42 to 0.95 for cypress (p &lt; 0.05), and 2.86 to 2.07 for house dust (p &lt; 0.01). Our survey of the patients’ clinical records indicates that 47.5% of the pollinosis patients reported improvement in nasal symptoms after the three seasons of pollen dispersion in the COVID era. Japan’s quarantine policies designed to combat the spread of COVID-19 thus coincide with pivotal measures to alleviate allergic reactions.

Efficacy of Vidian Neurectomy and Posterior Nasal Neurectomy in the Management of Nonallergic Rhinitis: A Systematic Review.

Nonallergic rhinitis (NAR) is characterized by rhinorrhea, nasal obstruction, and sneezing, in the absence of systemic sensitization to allergens. For cases refractory to medical therapy and conservative surgical interventions, more targeted procedures, such as endoscopic vidian neurectomy (EVN) and posterior nasal neurectomy (PNN), including surgical (SPNN) and cryoablative (CPNN) methods, may reduce symptoms of NAR. The purpose of this study was to compare the efficacy, side effect profile, and complication rate between EVN and PNN for NAR. A systematic review of primary articles that reported original patient data for either EVN or PNN was conducted using Embase, Medline, PubMed, and Cochrane databases since 2006, according to PRISMA guidelines. The primary outcome of the study was an improvement in NAR symptom severity. Secondary outcomes included the incidence of postoperative side effects or complications. In total, 58 articles met the search criteria with a total of 9 studies (including 2 RCTs) eligible for inclusion. There was a pooled sample of 229 NAR patients that underwent EVN (n = 65; 28.4%), SPNN (n = 50; 21.8%), or CPNN (n = 114; 49.8%). For all 3 techniques, there was a statistically significant improvement in nasal symptoms, particularly rhinorrhea, nasal congestion, and obstruction along with quality of life. Heterogeneity in outcome reporting prevented meta-analysis and direct comparison of efficacy. The pooled incidence of postoperative complications for EVN (n = 65), SPNN (n = 50), and CPNN (n = 70) was 30.8% versus 0% versus 2.9% for dry eye, 16.9% versus 0% versus 1.4% for palatal/cheek numbness, and 0% versus 6% versus 4.3% for bleeding. EVN, SPNN, and CPNN are similarly efficacious for patients with NAR refractory to medical management. SPNN and CPNN are associated with lower rates of complications (dry eye and palatal/cheek numbness) compared with EVN.

Rapid and Continuing Improvements in Nasal Symptoms with Dupilumab in Patients with Severe CRSwNP.

PurposeIn the phase 3 SINUS-24 (NCT02912468) and SINUS-52 (NCT02898454) studies in adults with severe chronic rhinosinusitis with nasal polyps (CRSwNP), dupilumab significantly improved the co-primary endpoints of change from baseline to Week 24 in nasal polyp score (NPS) and nasal congestion/obstruction (NC) vs placebo on background intranasal corticosteroids (standard of care [SOC]). This post hoc analysis of SINUS-24/-52 investigated the direction and magnitude of within-patient change in these endpoints over time.MethodsNPS (scale 0–8) was assessed at Weeks 4, 8, 16, 24, 40, and 52 in SINUS-52 and Weeks 8, 16, and 24 in SINUS-24. Daily patient-reported NC scores (0 [no symptoms]–3 [severe symptoms]) were averaged over 28 days. Within-patient changes from baseline were assessed through Week 24 in pooled SINUS-24/-52 (n = 438/286 dupilumab/SOC) and through Week 52 in SINUS-52 (n = 150/153).ResultsIn SINUS-52, NPS improved in 70.0% of dupilumab-treated patients at Week 4 vs 31.8% with SOC (odds ratio [OR] 5.2 [95% confidence interval 3.1–8.8]) and 78.7% vs 28.2% at Week 52 (OR 10.6 [6.0–18.7]) (all p < 0.0001). NC improved in 73.3% of dupilumab-treated patients at Week 4 vs 46.7% with SOC (OR 3.2 [2.0–5.3]) and 86.9% vs 50.7% at Week 52 (OR 6.4 [3.5–11.5]) (all p < 0.0001). Clinically meaningful (≥1 point) improvements in NPS occurred in 55.7% and 72.3% of dupilumab-treated patients at Weeks 4 and 52, respectively, vs 16.9% and 16.2% with SOC. Clinically meaningful (≥1 point) improvements in NC occurred in 16.7% and 67.6% of dupilumab-treated patients at Weeks 4 and 52, respectively, vs 3.9% and 20.8% with SOC. At Week 52, NPS worsening from baseline was observed in 5.7% of dupilumab-treated patients vs 40.1% with SOC and NC worsening in 2.1% vs 20.8%, respectively.ConclusionDupilumab provided rapid, continuing, and clinically relevant improvements over time in NPS and NC in most patients with severe CRSwNP in the SINUS studies.

Clinical Efficacy and Safety of Artesimia annua-Sublingual Immunotherapy in Seasonal Allergic Rhinitis Patients Based on Different Intervention Time

Introduction: Artemisia is a major kind of grass pollen in Northern China that can cause multiple kinds of common allergic diseases, such as allergic rhinitis (AR), conjunctivitis, or asthma. Recently, Artemisia annua Allergens Sublingual Immunotherapy Drops have been proved effective and safe for treating seasonal AR (SAR) with or without allergic conjunctivitis patients and were available in China. We sought to further investigate the different intervention times of A. annua-sublingual immunotherapy (SLIT) for evaluating efficacy and safety in patients with SAR. Methods: A total of 88 subjects aged 18–52 years with SAR were enrolled and randomized into the SLIT group and control group. Forty-five patients received a course of SLIT with A. annua extracts along with pharmacotherapy as SLIT group and 43 patients only used symptomatic drugs as control group. Furthermore, SLIT group was randomly divided into 12–13 weeks’ pre-seasonal treatment group and 8–9 weeks’ pre-seasonal treatment group to receive different duration of SLIT before pollen season. Monosensitized and polysensitized groups were also the subgroups of SLIT group according to the sensitization status of patients. The combined symptom and medication score (CSMS), total nasal symptom score (TNSS), total medication score (TMS), visual analog score (VAS) were evaluated during the peak pollen phase in 2020 and 2021, respectively. Safety was assessed according to adverse events (AEs) reported. Results: Compared to control group, CSMS, TNSS, TMS, VAS were significantly improved during the course of SLIT (p < 0.001). Besides, clinical improvement in nasal symptoms and reduction of medication use was also observed in SLIT group, compared to the baseline value (p < 0.001). Meanwhile, we observed that there was no significant difference between monosensitized group (n = 8) and polysensitized group (n = 29), as well as 12–13 weeks’ preseasonal treatment group (n = 20) and 8–9 weeks’ pre-seasonal treatment group (n = 17) belonging to the SLIT group in clinical efficacy (p > 0.05). No severe systemic AEs were reported. Conclusions: This study proved that A. annua-SLIT can provide equivalent efficacy and safety for SAR patients under the circumstance of accepting the pre-seasonal treatment of 8–9 or 12–13 weeks, regardless of monosensitization or polysensitization.

Twelve-year long-term postoperative outcomes in patients with chronic rhinosinusitis with nasal polyps.

Evidence regarding long-term postoperative follow-up of chronic rhinosinusitis with nasal polyps (CRSwNP) patients is scarce in the literature. The objective of the present study was to report long-term 12-year postoperative outcomes for CRSwNP patients. CRSwNP patients were prospectively followed after endoscopic sinus surgery. Sinonasal symptoms, nasal polyp score (NPS), Barcelona Smell Test 24 (BAST-24), Lund-Mackay Score (LMS), and Medical Outcome Study Short Form-36 (SF-36) questionnaire were assessed before and 12 years after surgery. At long-term follow-up (median, 12 years), a strong improvement was noted for all patients (N=76) in nasal symptoms score, NPS, BAST-24, and LMS scores compared with baseline. No long-term improvement in SF-36 was found. Patients with CRSwNP have a long-term 12-year postoperative improvement in nasal symptoms, polyp size, computed tomography, and olfaction.