Volume 10 Supplement 2
Anti-Ige monoclonal antibody therapy for the treatment of patients with chronic rhinosinusitis: a multi-disciplinary practice review
© Kilty et al; licensee BioMed Central Ltd. 2014
Published: 18 December 2014
Several treatment options have been described for chronic rhinosinusitis (CRS), yet many patients remain poorly responsive to medical and surgical therapy. Recently, anti-IgE monoclonal antibody has emerged as a potential therapy for CRS. However, to date evidence for its efficacy in this patient population is sparse. The purpose of this study is to evaluate the clinical effect of anti-IgE monoclonal antibody therapy for patients with recalcitrant CRS and asthma treated in a multi-disciplinary clinic.
A review of the charts for the 194 patients on anti-IgE monoclonal antibody therapy was performed. 20 patients diagnosed with CRS with poorly controlled disease having failed surgical and/or medical therapy were identified. Data extraction targeted demographic details, asthma, environmental allergy and CRS specific disease related data. For data analysis, for nonparametric data the Mann-Whitney test was used and for binary data Fisher’s exact test was used.
Mean age of the cohort was 49 years (range 33-67); eleven patients were male. Mean IgE level was 331.14 IU/ml (57.54-1338.96 IU/ml). Mean treatment duration was 17 (3-71) months. The most common skin prick test positive environmental allergens were dust mite (100%) and cat (65%). 75% of patients had CRS with polyps. Six patients (30%) had AERD. The mean polyp score decreased from 1.8 to 1.0 (p=0.106). Patient olfaction improved in 11 patients (55%) with therapy. Two patients on chronic prednisone treatment were able to discontinue this treatment. None of the patients progressed to require surgical treatment.
Anti-IgE monoclonal antibody therapy allowed for clinical CRS disease control in this cohort of patients with severe and recalcitrant CRS. A well-designed clinical trial is needed to further assess the efficacy and safety of this treatment in the CRS population.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.