Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis

Gayatri B. Patel; Elizabeth A. Kudlaty; Amina Guo; Chen Yeh; Margaret S. Kim; Caroline P.E. Price; David Conley; Leslie C. Grammer; Ravi Kalhan; Robert C. Kern; Kris G. McGrath; Bruce K. Tan; Sharon R. Rosenberg; Robert P. Schleimer; Stephanie S. Smith; Whitney W. Stevens; Kevin C. Welch; Anju T. Peters

doi:10.2500/aap.2021.42.210058

Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis

Gayatri B. Patel, Elizabeth A. Kudlaty, Amina Guo, Chen Yeh, Margaret S. Kim, Caroline P.E. Price, David Conley, Leslie C. Grammer, Ravi Kalhan, Robert C. Kern, Kris G. McGrath, Bruce K. Tan, Sharon R. Rosenberg, Robert P. Schleimer, Stephanie S. Smith, Whitney W. Stevens, Kevin C. Welch, Anju T. Peters^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Background: Acute exacerbations of chronic rhinosinusitis (AECRS) are associated with significant morbidity and decreased quality of life. There are sparse data assessing the real-world impact of biologics on AECRS. Objectives: We sought to determine the impact of type 2-targeting biologics on the frequency of medication use for AECRS episodes. Methods: Antibiotic and/or systemic corticosteroid courses for AECRS were identified in a retrospective study from November 2015 to February 2020, at a single academic health system. The estimated yearly rates for antibiotic and corticosteroid courses were evaluated before and after initiation of type 2 biologics. Results: One-hundred and sixty-five patients with chronic rhinosinusitis (CRS) had received either omalizumab (n = 12), mepolizumab (n = 42), benralizumab (n = 44), dupilumab (n = 61), or reslizumab (n = 6). Seventy percent had CRS with nasal polyps, and 30% had CRS without nasal polyps. All the patients had asthma. When all the biologics were combined, the estimated yearly rate for antibiotics for AECRS decreased from 1.34 (95% confidence interval [CI], 1.12-1.59) to 0.68 (95% CI, 0.52-0.88) with biologic use (49% reduction, p < 0.001). Those with frequent AECRS (three or more courses of antibiotics in the 1 year before biologic use) had a larger degree of reduction, with an estimated yearly rate of 4.15 (95% CI, 3.79-4.55) to 1.58 (95% CI, 1.06-2.35) with biologic use (n = 27; 62% reduction; p < 0.001). Within the total cohort, the estimated yearly rate for systemic corticosteroids for AECRS decreased from 1.69 (95% CI, 1.42-2.02) to 0.68 (95% CI, 0.53-0.88) with biologic use (60% reduction; p < 0.001). Conclusion: Type 2-targeting biologics reduced medication use for AECRS. This suggested that biologics may be a therapeutic option for patients with frequent AECRS.

Original language	English (US)
Pages (from-to)	417-424
Number of pages	8
Journal	Allergy and asthma proceedings
Volume	42
Issue number	5
DOIs	https://doi.org/10.2500/aap.2021.42.210058
State	Published - Sep 1 2021

Funding

From the 1Division of Allergy and Immunology, Department of Medicine, Northwestern and Genentech. B.K. Tan has served on advisory boards for Sanofi/Genzyme and University Feinberg School of MDO edicine, Chicago, Illinois, 2Division of Biostatistics, Optinose. R.P. Schleimer is a consultant for Intersect ENT, GSK, Merck, Sanofi, Department of Preventive Medicine, Northwestern University Feinberg School of AstraZeneca/Medimmune, Genentech, Otsuka, Actobio Therapeutics, Lyra Medicine, Chicago, Illinois, 3Division of Pulmonary and Critical Care, Department of Therapeutics, Astellas Pharm Inc, Genzyme/Sanofi Corp, and Celgene Corp; is also a Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, consultant with stock/stock options that are not valued yet with Allakos, Aurasense, and 4Department of Otolaryngology–Head and Neck Surgery, Northwestern BioMarck, Exicure, and Aqualung Therapeutics Corp. W.W. Stevens has served on an University Feinberg School of Medicine, Chicago, Illinois advisory board for GSK. A.T. Peters reports personal fees from Sanofi/Regeneron, This work was supported by National Institutes of Health grants: Chronic Rhinosinusitis grants and fees from AstraZeneca and Optinose, outside the submitted work. The Integrative Studies Program P01AI145818, T32AI083216, R01AI137174; Division of remaining authors have no conflicts of interest pertaining to this article Allergy and Immunology, Department of Medicine, Northwestern University Feinberg Address correspondence to Anju Peters, M.D., Division of Allergy and Immunology, School of Medicine; and by the Ernest Bazley Foundation Feinberg School of Medicine, Northwestern University, 211 E. Ontario St, Suite 1000, L.C. Grammer III serves as a consultant for Astellas Pharmaceuticals. R. Kalhan Chicago, IL 60611 reports grants and personal fees from Boehringer Ingelheim, PneumRx, Spiration, E-mail address: [email protected] AstraZeneca; also received personal fees from CVS Caremark, Aptus Health, Copyright © 2021, OceanSide Publications, Inc., U.S.A. GlaxoSmithKline (GSK), Boston Scientific, Boston Consulting Group, outside the sub- mitted work. R.C. Kern is a consultant of Lyra Therapeutics, Sanofi/Regeneron, GSK,

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Immunology and Allergy

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Patel, G. B., Kudlaty, E. A., Guo, A., Yeh, C., Kim, M. S., Price, C. P. E., Conley, D., Grammer, L. C., Kalhan, R., Kern, R. C., McGrath, K. G., Tan, B. K., Rosenberg, S. R., Schleimer, R. P., Smith, S. S., Stevens, W. W., Welch, K. C., & Peters, A. T. (2021). Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis. Allergy and asthma proceedings, 42(5), 417-424. https://doi.org/10.2500/aap.2021.42.210058

@article{21d0b36047e440c8b58834c0a6987964,

title = "Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis",

abstract = "Background: Acute exacerbations of chronic rhinosinusitis (AECRS) are associated with significant morbidity and decreased quality of life. There are sparse data assessing the real-world impact of biologics on AECRS. Objectives: We sought to determine the impact of type 2-targeting biologics on the frequency of medication use for AECRS episodes. Methods: Antibiotic and/or systemic corticosteroid courses for AECRS were identified in a retrospective study from November 2015 to February 2020, at a single academic health system. The estimated yearly rates for antibiotic and corticosteroid courses were evaluated before and after initiation of type 2 biologics. Results: One-hundred and sixty-five patients with chronic rhinosinusitis (CRS) had received either omalizumab (n = 12), mepolizumab (n = 42), benralizumab (n = 44), dupilumab (n = 61), or reslizumab (n = 6). Seventy percent had CRS with nasal polyps, and 30% had CRS without nasal polyps. All the patients had asthma. When all the biologics were combined, the estimated yearly rate for antibiotics for AECRS decreased from 1.34 (95% confidence interval [CI], 1.12-1.59) to 0.68 (95% CI, 0.52-0.88) with biologic use (49% reduction, p < 0.001). Those with frequent AECRS (three or more courses of antibiotics in the 1 year before biologic use) had a larger degree of reduction, with an estimated yearly rate of 4.15 (95% CI, 3.79-4.55) to 1.58 (95% CI, 1.06-2.35) with biologic use (n = 27; 62% reduction; p < 0.001). Within the total cohort, the estimated yearly rate for systemic corticosteroids for AECRS decreased from 1.69 (95% CI, 1.42-2.02) to 0.68 (95% CI, 0.53-0.88) with biologic use (60% reduction; p < 0.001). Conclusion: Type 2-targeting biologics reduced medication use for AECRS. This suggested that biologics may be a therapeutic option for patients with frequent AECRS.",

author = "Patel, {Gayatri B.} and Kudlaty, {Elizabeth A.} and Amina Guo and Chen Yeh and Kim, {Margaret S.} and Price, {Caroline P.E.} and David Conley and Grammer, {Leslie C.} and Ravi Kalhan and Kern, {Robert C.} and McGrath, {Kris G.} and Tan, {Bruce K.} and Rosenberg, {Sharon R.} and Schleimer, {Robert P.} and Smith, {Stephanie S.} and Stevens, {Whitney W.} and Welch, {Kevin C.} and Peters, {Anju T.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2021, OceanSide Publications, Inc., U.S.A.",

year = "2021",

month = sep,

day = "1",

doi = "10.2500/aap.2021.42.210058",

language = "English (US)",

volume = "42",

pages = "417--424",

journal = "Allergy and asthma proceedings",

issn = "1088-5412",

publisher = "OceanSide Publications Inc.",

number = "5",

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Patel, GB, Kudlaty, EA, Guo, A, Yeh, C, Kim, MS, Price, CPE, Conley, D , Grammer, LC , Kalhan, R , Kern, RC , McGrath, KG , Tan, BK , Rosenberg, SR , Schleimer, RP , Smith, SS , Stevens, WW , Welch, KC & Peters, AT 2021, 'Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis', Allergy and asthma proceedings, vol. 42, no. 5, pp. 417-424. https://doi.org/10.2500/aap.2021.42.210058

TY - JOUR

T1 - Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis

AU - Patel, Gayatri B.

AU - Kudlaty, Elizabeth A.

AU - Guo, Amina

AU - Yeh, Chen

AU - Kim, Margaret S.

AU - Price, Caroline P.E.

AU - Conley, David

AU - Grammer, Leslie C.

AU - Kalhan, Ravi

AU - Kern, Robert C.

AU - McGrath, Kris G.

AU - Tan, Bruce K.

AU - Rosenberg, Sharon R.

AU - Schleimer, Robert P.

AU - Smith, Stephanie S.

AU - Stevens, Whitney W.

AU - Welch, Kevin C.

AU - Peters, Anju T.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - Background: Acute exacerbations of chronic rhinosinusitis (AECRS) are associated with significant morbidity and decreased quality of life. There are sparse data assessing the real-world impact of biologics on AECRS. Objectives: We sought to determine the impact of type 2-targeting biologics on the frequency of medication use for AECRS episodes. Methods: Antibiotic and/or systemic corticosteroid courses for AECRS were identified in a retrospective study from November 2015 to February 2020, at a single academic health system. The estimated yearly rates for antibiotic and corticosteroid courses were evaluated before and after initiation of type 2 biologics. Results: One-hundred and sixty-five patients with chronic rhinosinusitis (CRS) had received either omalizumab (n = 12), mepolizumab (n = 42), benralizumab (n = 44), dupilumab (n = 61), or reslizumab (n = 6). Seventy percent had CRS with nasal polyps, and 30% had CRS without nasal polyps. All the patients had asthma. When all the biologics were combined, the estimated yearly rate for antibiotics for AECRS decreased from 1.34 (95% confidence interval [CI], 1.12-1.59) to 0.68 (95% CI, 0.52-0.88) with biologic use (49% reduction, p < 0.001). Those with frequent AECRS (three or more courses of antibiotics in the 1 year before biologic use) had a larger degree of reduction, with an estimated yearly rate of 4.15 (95% CI, 3.79-4.55) to 1.58 (95% CI, 1.06-2.35) with biologic use (n = 27; 62% reduction; p < 0.001). Within the total cohort, the estimated yearly rate for systemic corticosteroids for AECRS decreased from 1.69 (95% CI, 1.42-2.02) to 0.68 (95% CI, 0.53-0.88) with biologic use (60% reduction; p < 0.001). Conclusion: Type 2-targeting biologics reduced medication use for AECRS. This suggested that biologics may be a therapeutic option for patients with frequent AECRS.

AB - Background: Acute exacerbations of chronic rhinosinusitis (AECRS) are associated with significant morbidity and decreased quality of life. There are sparse data assessing the real-world impact of biologics on AECRS. Objectives: We sought to determine the impact of type 2-targeting biologics on the frequency of medication use for AECRS episodes. Methods: Antibiotic and/or systemic corticosteroid courses for AECRS were identified in a retrospective study from November 2015 to February 2020, at a single academic health system. The estimated yearly rates for antibiotic and corticosteroid courses were evaluated before and after initiation of type 2 biologics. Results: One-hundred and sixty-five patients with chronic rhinosinusitis (CRS) had received either omalizumab (n = 12), mepolizumab (n = 42), benralizumab (n = 44), dupilumab (n = 61), or reslizumab (n = 6). Seventy percent had CRS with nasal polyps, and 30% had CRS without nasal polyps. All the patients had asthma. When all the biologics were combined, the estimated yearly rate for antibiotics for AECRS decreased from 1.34 (95% confidence interval [CI], 1.12-1.59) to 0.68 (95% CI, 0.52-0.88) with biologic use (49% reduction, p < 0.001). Those with frequent AECRS (three or more courses of antibiotics in the 1 year before biologic use) had a larger degree of reduction, with an estimated yearly rate of 4.15 (95% CI, 3.79-4.55) to 1.58 (95% CI, 1.06-2.35) with biologic use (n = 27; 62% reduction; p < 0.001). Within the total cohort, the estimated yearly rate for systemic corticosteroids for AECRS decreased from 1.69 (95% CI, 1.42-2.02) to 0.68 (95% CI, 0.53-0.88) with biologic use (60% reduction; p < 0.001). Conclusion: Type 2-targeting biologics reduced medication use for AECRS. This suggested that biologics may be a therapeutic option for patients with frequent AECRS.

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Impact of type 2 targeting biologics on acute exacerbations of chronic rhinosinusitis

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