Modern view on the problem of therapy of recurrent polyposis rhinosinusitis, comparative study of the effectiveness of different monoclonal antibody preparations

Introduction. The main methods of treatment of patients with chronic polyposis rhinosinusitis are surgical and conservative, despite the significant successes achieved in the treatment of the polyposis process, epidemiologic and clinical studies show that there is no complete control of this disease. Taking into account the pros and cons of the above-mentioned methods of treatment, it seems relevant for the scientific community to further search for new methods that will combine high efficacy and low probability of developing undesirable systemic manifestations. One of such methods is targeted biological therapy with the use of monoclonal antibodies.

Aim. To evaluate the efficacy of monoclonal antibodies in the therapy of patients with polyposis rhinosinusitis.

Materials and methods. The authors studied the outpatient records of 102 patients aged 20 to 87 years, in whose therapy monoclonal antibodies (dupilumab, omalizumab, mepolizumab) were used. All patients participating had concomitant pathology in the form of chronic recurrent polyposis rhinosinusitis with the main disease – bronchial asthma. The subjects were divided into 3 groups, in the treatment of which one of the monoclonal antibody preparations was used.

Results and discussion. Regression of the main symptoms of chronic polyposis rhinosinusitis (loss of sense of smell and taste, pain/pressure in the facial area, reduction of runny nose, mucus flowing down the posterior pharyngeal wall, nasal congestion) was observed in each of the 3 groups against the background of therapy with monoclonal antibodies. The effectiveness of the therapy was evaluated according to the results of endoscopic picture (Lund-Kennedy scale), CT picture (Lund-Mackay scale) and the data of subjective questionnaire SNOT-22.

Conclusion. The studied molecules showed efficacy in the therapy of chronic polyposis rhinosinusitis. However, dupilumab was the most preferable molecule, the use of which allows to achieve more pronounced regression of the main clinical symptomatology, to reduce the degree of recurrence of the polyposis process with the absence of the need for repeated surgical interventions, as well as allows to improve the quality of life of patients.

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