Dupilumab may rapidly improve sleep parameters among patients with chronic rhinosinusitis and nasal polyps

Written by Aditi Published On 2023-10-30T14:30:28+05:30 | Updated On 31 Oct 2023 10:17 AM IST

Chronic rhinosinusitis (CRS) is a prolonged inflammation of the sinus (nasal cavity and paranasal) and is classified into CRSwNP (CRS with nasal polyps) and CRSsNP (CRS without nasal polyps) . The condition lasts for at least 12 weeks and severely impairs the patient's life quality and sleep parameters. The present study found that Dupilumab improves sleep parameters in CRSwNP patients.

This study was published in the Annals of Allergy, Asthma & Immunology entitled "Sleep quality burden in chronic rhinosinusitis with nasal polyps and its modulation by Dupilumab" by Ferri et al. and colleagues.

CRSwNP is tied to impaired sleep quality. The most common CRSwNP endotype is characterized by type-2 inflammation. The condition is associated with greater interleukin (IL)-4, IL-5 and IL-13 production. Dupilumab is a monoclonal antibody against IL-4 receptor-alpha. The drug inhibits both IL-4 and IL-13 signalling and is approved for treating CRSwNP.

In the present study, researchers investigated Dupilumab's effect on sleep quality in these patients (evaluated at baseline and after 1 and 3 months of treatment) using the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) and Sinonasal Outcome Test 22 (SNOT-22) sleep domain.

The key points of the study are:

Researchers enrolled Twenty-nine consecutive patients.
The baseline sleep quality assessment were: ESS 7.9 +/- 4.5; ISI 13.1 +/- 6.2; PSQI 9.2 +/- 3.7; SNOT-22 sleep domain: 12.1 +/- 4.2.
24.1%, 79.3% and 93.1% had excessive daily sleepiness, insomnia and globally impaired sleep quality.
Dupilumab improved ESS, ISI, PSQI and SNOT-22 sleep domain, with concomitant reduction of the proportion of patients with insomnia and globally impaired sleep quality.

Concluding further, they said, in our study, we found that CRSwNP significantly impacts global sleep quality, especially insomnia. Dupilumab induced a rapid improvement in all the sleep quality parameters.

The study highlights an important consideration: sleep disturbances should be more carefully evaluated in these patients as an additional outcome.