Omalizumab Improves CRS With Nasal Polyps, Regardless of Asthma Status

After careful consideration, the American Academy of Allergy, Asthma & Immunology canceled its annual meeting that was to take place in Philadelphia, Pennsylvania from March 13 to 16, because of concerns regarding the coronavirus disease 2019 (COVID-19) outbreak. Although the live events will not proceed as planned, our readers can still find coverage of research that was scheduled to be presented at the meeting.

The use of omalizumab therapy in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), regardless of their asthma status, was associated with improvements in nasal polyps score (NPS), nasal congestion score (NCS), and sino-nasal outcome test (SNOT-22) score.

A subgroup analysis of pooled data from the 24-week, phase 3, placebo-controlled omalizumab trials (POLYP1; ClinicalTrials.gov Identifier: NCT03280550 and POLYP2; ClinicalTrials.gov Identifier: NCT03280537) was conducted in adult patients with corticosteroid-refractory CRSwNP, both with and without asthma. Results of the analysis were intended to be presented at the American Academy of Allergy Asthma & Immunology (AAAAI) 2020 Annual Meeting.

Recognizing that CRSwNP and asthma frequently coexist, investigators sought to examine whether treatment with the anti-immunoglobulin E monoclonal antibody omalizumab is associated with different outcomes in patients with CRSwNP with or without comorbid asthma. They calculated placebo-adjusted effects from baseline at week 24 for NPS, NCS, and SNOT-22.

A total of 265 patients were included in the analysis, of whom 151 had comorbid asthma and 114 did not have comorbid asthma, which translated into 57.0% of the pooled population of patients evaluated having asthma. According to physicians’ assessment, in patients with asthma, 35.1% had disease of mild severity, 58.3% had disease of moderate severity, and 6.6% had severe asthma.

Across all 3 end points (changes in NPS, NCS, and SNOT-22), improvements from baseline at week 24 were significantly greater in patients treated with omalizumab compared with patients who received placebo. Furthermore, in the asthma and nonasthma groups, improvements were similar across all 3 end points, with the following placebo-adjusted effects reported: NPS: -0.98 (P <.0001) and -0.72 (P =.0054), respectively; NCS: -0.52 (P =.0003) and -0.56 (P =.0007), respectively; and SNOT-22: -14.82 (P <.0001) and -16.14 (P <.0001), respectively. Adverse events were similar between the 2 study groups.

The investigators concluded that in patients with CRSwNP, no marked differences were observed between those with asthma and those without asthma. It remains unclear, however, whether these results will extend to the population of patients with severe asthma, as the group in the analysis was small compared with those with mild or moderate disease.

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Reference

Bachert C, Gevaert P, Corren J, et al. Omalizumab improves outcomes in patients with chronic rhinosinusitis with nasal polyps irrespective of asthma status. J Allergy Clin Immunol. 2020;145(Suppl 2):AB149.

This article originally appeared on Pulmonology Advisor