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United airways: a concept challenged by IL5R blockade?
Mémoire de Master / Thèse d'exercice

United airways: a concept challenged by IL5R blockade?

Marion Tabardel
Masters , Université de Montpellier
14/04/2022

Résumé

Severe asthma Chronic rhinosinusitis with nasal polyps Type 2 inflammation Benralizumab Sinus CT scan Lund-MacKay score Frontal sinus hypoplasia Asthme sévère Polypose naso-sinusienne Inflammation type 2 Benralizumab Scanner des sinus Score de Lund-MacKay Hypoplasie des sinus frontaux Eosinophilia Éosinophilie
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is one of the most frequent comorbidities in severe asthma and has been associated with an increased overall disease burden. Biological therapies targeting type 2 inflammation are the most innovative therapies for both severe asthma and uncontrolled CRSwNP. Benralizumab is now largely used in patients with uncontrolled eosinophilic severe asthma and recent studies showed its efficacy in CRSwNP. Our aim was to study the correlation between sinus and asthma treatment responses in patients initiated with Benralizumab. METHODS: a prospective, two-center study (Montpellier and Marseille) was performed using the database from the Benraliscan study. We included severe eosinophilic asthma patients. They received Benralizumab for 48 weeks. The sinus and asthma treatment responses were assessed using clinical questionnaires, spirometries, eosinophil counts, and sinus CT scans at baseline and after one year. RESULTS: between June 20, 2019, and January 26, 2022, we included 54 patients. 31 completed the 52- week study period. No significant correlation was found between sinus and asthma treatment responses. 34 patients had nasal polyps at inclusion. They were significantly more symptomatic on ACQ6 (p=0.033). The presence of respiratory allergies was a predictor of poor asthma treatment response (p= 0.016). CONCLUSION: this study confirmed the association between severe asthma and CRSwNP. Although, we did not find an association between sinus and asthma Benralizumab response. Uncovering the mechanism behind the different degrees of response on both asthma and CRSwNP remains a question of interest.

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