Impact of Overweight on Response to Dupilumab Treatment in Chronic Rhinosinusitis with Nasal Polyps
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects and Study Design
2.2. Criteria for Dupilumab Treatment
2.3. Clinical Assessment
2.4. Outcome Measures
2.5. Statistics
3. Results
3.1. Baseline Characteristics
3.2. Dupilumab Treatment Outcome of the Total Cohort
3.3. Dupilumab Treatment Outcome According to Weight Groups
3.4. Weight Subgroups Analysis of Dupilumab Treatment Outcome
3.4.1. N-ERD Weight Subgroups
3.4.2. Asthma Weight Subgroups
3.5. BMI as Independent Prognostic Factor for NPS Outcome after Dupilumab Treatment
3.6. Side Effects and Blood Parameter Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Underweight/Normal Weight Group (n = 30) | Overweight/Obese Group (n = 45) | p-Value |
---|---|---|---|
Sex, f/m | 16/14 | 20/25 | 0.487 |
Age in years | 49.9 (SD 16.7) | 51.9 (13.3) | 0.570 |
Prior ESS | 2.7 (SD 1.7) | 2.2 (SD 1.4) | 0.257 |
n° (%) of indication criteria, 3/4/5 | 9 (30%)/10 (33%)/11 (37%) | 5 (11%)/23 (51%)/17 (38%) | 0.101 |
Evidence of type 2 inflammation | 27 (90%) | 44 (98%) | 0.295 |
Need of ≥2 courses systemic COS per year | 22 (73%) | 35 (78%) | 0.784 |
Impaired sense of smell | 28 (93%) | 44 (97%) | 0.560 |
Comorbid asthma | 22 (73%) | 28 (62%) | 0.454 |
N-ERD | 6 (20%) | 8 (18%) | 0.809 |
Baseline sEOS × 109/L | 0.43 (SD 0.2) | 0.48 (SD 2.1) | 0.485 |
Baseline total IgE × kU/L | 136.5 (SD 127.5) | 229.7 (SD 283.9) | 0.096 |
Parameter | Underweight/Normal Weight Group (n = 30) | Overweight/Obese Group (n = 45) | p-Value | Effect Size |
---|---|---|---|---|
Baseline NPS | 5.1 (SD 1.6) | 4.7 (SD 1.7) | 0.323 | - |
Follow-up NPS | 0.5 (SD 1.2) | 1.5 (SD 1.4) | 0.002 | d = 0.75 |
Change in NPS | −4.6 (SD 2) | −3.2 (SD 1.9) | 0.004 | d = 0.38 |
Reaching NPS of 0 | 23 (77%) | 13 (29%) | <0.001 | φ = 0.46 |
Baseline SNOT-22 | 52.6 (SD 20.3) | 58.5 (SD 20.9) | 0.231 | - |
Follow-up SNOT-22 | 16.7 (SD 15.9) | 31.1 (SD19.8) | 0.001 | d = 0.78 |
Change in SNOT-22 | −35.9 (SD 22.3) | −27.4 (SD 21.6) | 0.104 | - |
Clinically meaningful SNOT-22 change | 29 (97%) | 40 (89%) | 0.392 | - |
Parameter | Underweight/Normal Weight Group (n = 6) | Overweight/Obese Group (n = 8) | p-Value | Effect Size |
---|---|---|---|---|
Baseline NPS | 5.1 (SD 1.9) | 4.4 (SD 2.4) | 0.527 | - |
Follow-up NPS | 0.1 (SD 0.4) | 1.5 (SD 1.1) | 0.014 | d = 1.55 |
Change in NPS | −5 (SD 2) | −2.8 (SD 2.3) | 0.047 | d = 0.95 |
Reaching NPS of 0 | 5 (83%) | 1 (12%) | 0.026 | φ = 0.71 |
Baseline SNOT-22 | 58 (SD 23.2) | 54.8 (SD 12.5) | 0.751 | - |
Follow-up SNOT-22 | 6 (SD 5.4) | 30 (SD 23.5) | 0.030 | d = 1.32 |
Change in SNOT-22 | −52 (SD 21.6) | −24.6 (SD 24.3) | 0.025 | d = 1.17 |
Clinically meaningful SNOT-22 change | 6 (100%) | 7 (87%) | 0.571 | - |
Parameter | Underweight/Normal Weight Group (n = 22) | Overweight/Obese Group (n = 28) | p-Value | Effect Size |
---|---|---|---|---|
Baseline NPS | 4.9 (SD 1.8) | 4.5 (SD 1.4) | 0.410 | - |
Follow-up NPS | 0.5 (SD 1.3) | 1.4 (SD 1) | 0.011 | d = 0.749 |
Change in NPS | −4.5 (SD 2.1) | −3.1 (SD 1.4) | 0.014 | d = 0.728 |
Reaching a NPS of 0 | 17 (77%) | 7 (25%) | <0.001 | φ = 0.519 |
Baseline SNOT-22 | 53.5 (SD 18.5) | 55.1 (SD 19.8) | 0.783 | - |
Follow-up SNOT-22 | 18.5 (SD 17.1) | 31 (SD 22.7) | 0.037 | d = 0.610 |
Change in SNOT-22 | −35 (SD 19.9) | −24 (SD 18.7) | 0.026 | d = 0.570 |
Clinically meaningful SNOT-22 change | 21 (95%) | 25 (89%) | 0.621 | - |
Subjective asthma-symptoms improvement | 22 (100%) | 26 (92%) | 0.497 |
Parameter | Coefficient B | Standard Error | Standardized Beta | T | p-Value |
---|---|---|---|---|---|
BMI | 0.088 | 0.037 | 0.263 | 2.371 | 0.020 |
Age | −0.023 | 0.011 | −0.236 | −2.141 | 0.036 |
Parameter | Underweight/Normal Weight Group (n = 30) | Overweight/Obese Group (n = 45) | p-Value |
---|---|---|---|
Baseline sEOS | 0.43 (SD 0.2) | 0. 48 (SD 2.1) | 0.485 |
Follow-up sEOS | 0.59 (SD 0.4) | 0.70 (SD 0.5) | 0.370 |
Hypereosinophilia | 1 (3%) | 7 (15%) | 0.134 |
Baseline total IgE | 136.5 (SD 127.5) | 229.7 (SD 283.9) | 0.096 |
Follow-up total IgE | 62.2 (SD 66.3) | 99.9 (SD 133.1) | 0.155 |
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Habenbacher, M.; Moser, U.; Abaira, A.; Tomazic, P.V.; Kiss, P.; Holzmeister, C.; Pock, J.; Walla, K.; Lang, A.; Andrianakis, A. Impact of Overweight on Response to Dupilumab Treatment in Chronic Rhinosinusitis with Nasal Polyps. Nutrients 2024, 16, 2982. https://doi.org/10.3390/nu16172982
Habenbacher M, Moser U, Abaira A, Tomazic PV, Kiss P, Holzmeister C, Pock J, Walla K, Lang A, Andrianakis A. Impact of Overweight on Response to Dupilumab Treatment in Chronic Rhinosinusitis with Nasal Polyps. Nutrients. 2024; 16(17):2982. https://doi.org/10.3390/nu16172982
Chicago/Turabian StyleHabenbacher, Michael, Ulrich Moser, Ahmed Abaira, Peter Valentin Tomazic, Peter Kiss, Clemens Holzmeister, Jakob Pock, Katharina Walla, Angelika Lang, and Alexandros Andrianakis. 2024. "Impact of Overweight on Response to Dupilumab Treatment in Chronic Rhinosinusitis with Nasal Polyps" Nutrients 16, no. 17: 2982. https://doi.org/10.3390/nu16172982