Chronic rhinosinusitis with nasal polyps (CRSwNP), a type 2 inflammatory disease, substantially increases a patient’s likelihood of developing other conditions like asthma, underscoring the interconnected nature of these respiratory ailments adn the need for thorough treatment strategies, according to a study published in the Journal of Asthma and Allergy.1
Patients who experience CRSwNP may experience facial pressure, absent sense of smell, nasal congestion, runny nose, sore throat, postnasal drip, headaches, snoring, and tooth pain.2 Tobacco smoke, chemicals, allergens like pollen, strong scents, and aspirin or other non-steroidal anti-inflammatory drugs can trigger symptoms.
The presence of coexisting asthma associates with more severe sinus disease,higher rates of corticosteroid dependence,and lower health-related quality of life (HRQOL) with respect to both diseases.1 Patients with CRSwNP and asthma are more prone to sinonasal surgery than those with CRSwNP alone. Furthermore, asthma in these patients is more difficult to control and prone to exacerbations. Coexisting asthma increases the likelihood of sinonasal surgery for patients with CRSwNP.It also makes their asthma harder to control and more susceptible to flare-ups.
First-line therapies like nasal irrigation and topical corticosteroids often inadequately control crswnp. Second-line therapies such as oral corticosteroids provide only temporary improvement in HRQOL and reduction in polyp size, and they associate with systemic adverse events when used long-term.An unmet need exists for treatments that effectively improve both clinical markers and associated HRQOL in either or both diseases.
Dupilumab significantly improved both objective and patient-reported outcomes for patients with severe, uncontrolled CRSwNP. Other studies have found dupilumab efficacious in subpopulations of patients with chronic rhinosinusitis with nasal polyps and asthma. During a case reported study,dupilumab use led the patient to experience no acute exacerbation of chronic rhinosinusitis,no adverse symptoms related to dupilumab,the sinusitis symptoms were fully controlled,and the subjective score of smell significantly improved,after the first dose.3
The AROMA study (Nct04959448) focuses on real-world evidence by collecting data on dupilumab’s long-term effectiveness, as represented by changes in patient-reported outcomes and HRQOL over time. It also aim