“Smell improvement by anti-IgE and anti-IL 5 biologics in patients with
CRSwNP and severe asthma– A real life study”
Abstract
Background. Chronic rhinosinusitis with nasal polyps (CRSwNP),
characterized by partial (hyposmia) or total (anosmia) loss of smell, is
commonly associated with asthma and/or nonsteroidal anti-inflammatory
drug-exacerbated respiratory disease (N-ERD), worsens disease severity
and quality of life. The objective of this study was to determine
whether, in real-life conditions, biological treatments prescribed for
severe asthma can improve olfaction in patients with CRSwNP. A further
objective was to compare smell improvement in N-ERD and non-N-ERD
subgroups. Methods. A multicenter, non-interventional,
retrospective, observational study was performed, including 206 patients
with severe asthma undergoing biological treatment (omalizumab,
mepolizumab, benralizumab, or reslizumab) with CRSwNP. Results.
Improved olfaction was found after treatment with all monoclonal
antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab
(35.7%), and benralizumab (39.1%), with no differences between groups.
Patients with atopy, greater use of short course systemic
corticosteroids, and larger polyp size were more likely to experience
improvement in smell. The proportion of patients experiencing smell
improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%)
groups. Conclusions. This is the first study to compare
real-life improvement in sense of smell among patients undergoing
long-term treatment with omalizumab, mepolizumab, reslizumab, or
benralizumab for severe asthma and associated CRSwNP. Approximately 4
out of 10 patients reported a subjective improvement in sense of smell
(with non-significant differences between biologic drugs). No
differences were found in smell improvement between the N-ERD and
non-N-ERD group.