Correlation of clinical symptoms, differential blood count and lung function under biological therapy in severe chronic sinusitis with nasal polyps

Introduction The improvement of comorbidities, including bronchial asthma, is an aspect of evaluating the effectiveness of biological therapy, in addition to the improvement in sinunasal symptoms. The aim of the prospective study was to investigate the correlation of clinical, laboratory and lung function parameters under biological therapy.

Methods 66 patients (♀:36,♂:30; mean age 49.9 ± 12.2 years) with a duration of therapy > 6 months were included, with 48 patients receiving dupilumab and 12 patients receiving omalizumab. In all patients, the clinical symptoms were recorded using visual analogue scales, lung function diagnostics and the evaluation of the differential blood count before the start of therapy, after 6 and 12 months.

Results The mean FEV1% at baseline was 80.14 ± 21.6% and correlated with improvements in FEV1 at 6 months (0.275; p<0.003) and 12 months (0.393, p<0.002). The reduction in facial pressure (0.324, p<0.034) and nasal obstruction (0.406; p<0.016) as well as in post nasal drip (0.45; p<0.009) and headache (0.372; p<0.042) showed a significant correlation to improvement in FEV1 at 6 and 12 months, respectively. A low occlusal resistance (Rocc) before start of therapy was associated with a high total therapy score (-0.415; p<0.012). The eosinophil count (relative/absolute) showed no significant correlation to the improvement in lung function or sinunasal symptoms.

Discussion Our results show the close association between sinunasal symptoms and lung function. This aspect supports the "Combined Airway Concept", based on similar pathophysiological patterns of inflammation in the upper and lower airways.

Publication History

Article published online:
12 May 2023