Evaluation of Asthma Control in Patients with and without Sinonasal Polyps following Treatment with Biologic Agents

Authors

Prachi Patel, Thomas Jefferson UniversityFollow
Chandala Chitguppi, MD, Thomas Jefferson UniversityFollow
Alan Gandler, MD, Thomas Jefferson University
Kira Murphy, MD, Thomas Jefferson UniversityFollow
Tawfiq Khoury, MD, Thomas Jefferson UniversityFollow
Stephanie Bork, CRNP, Thomas Jefferson UniversityFollow
Pamela Monostra, PA, Thomas Jefferson UniversityFollow
Elina Toskala, MD, PhD, Thomas Jefferson UniversityFollow
Mindy Rabinowitz, MD, Thomas Jefferson University HospitalFollow
Marc Rosen, MD, Thomas Jefferson UniversityFollow
Gurston Nyquist, MD, Thomas Jefferson UniversityFollow
Jessica Most, MD, Thomas Jefferson UniversityFollow

Abstract

Background: The effects of biologics on severe asthmatics with chronic rhinosinusitis with sinonasal polyposis (CRSwNP) have not been well established. This study evaluates overall control of asthma in patients with and without sinonasal polyps following initiation of biologics therapy.

Methods: Retrospective review of patients with asthma treated with a biologic agent (benralizumab, omalizumab, dupilumab, mepolizumab) and CRSwNP. Charts were assessed for ACT scores at time of biologic enrollment and at 4-7 months.

Results:82 patients met inclusion criteria; 42 (52.5%) patients with asthma and 40 (47.5%) with concurrent sinonasal polyps. The average ACT score for the non-polyp cohort was 13.16 + 4.12 at baseline, and 16.45 + 4.79 at long term follow-up; 15.85 + 3.13 and 20.19 + 1.68 in patients with polyps at both time points respectively. Patients with polyps had better control of their asthma at baseline (p=0.001), however both cohorts had overall poor baseline asthma control (ACT

Conclusions: Patients with and without sinonasal polyps who begin biologic therapy are shown to have significant improvements in their ACT score at follow-up. In addition, patients with polyps are shown to have significantly better control of their asthma while on biologics than patients with no polyps. Comorbid CRSwNP may predict response to biologic therapy in those with severe asthma (SA).

Recommended Citation

Patel, Prachi; Chitguppi, MD, Chandala; Gandler, MD, Alan; Murphy, MD, Kira; Khoury, MD, Tawfiq; Bork, CRNP, Stephanie; Monostra, PA, Pamela; Toskala, MD, PhD, Elina; Rabinowitz, MD, Mindy; Rosen, MD, Marc; Nyquist, MD, Gurston; and Most, MD, Jessica (2021) "Evaluation of Asthma Control in Patients with and without Sinonasal Polyps following Treatment with Biologic Agents," The Medicine Forum: Vol. 22, Article 21.
DOI: https://doi.org/10.29046/TMF.022.1.020
Available at: https://jdc.jefferson.edu/tmf/vol22/iss1/21