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Meta-Analysis
. 2024 Oct;14(10):1618-1633.
doi: 10.1002/alr.23453. Epub 2024 Sep 20.

Rheumatic adverse events associated with biologic therapy for chronic rhinosinusitis: A systematic review and meta-analysis

Jenny B Xiao  1 , Helen Hsiao  1 , Carlos Khalil  2 , John M Lee  2
Affiliations
Meta-Analysis

Rheumatic adverse events associated with biologic therapy for chronic rhinosinusitis: A systematic review and meta-analysis

Jenny B Xiao et al. Int Forum Allergy Rhinol. 2024 Oct.

Abstract

Background: Biologic therapies approved for treating chronic rhinosinusitis with nasal polyps (CRSwNP) have well-established safety profiles but reports of rheumatic adverse events (AEs) are increasing and not well defined. This review aims to assess the risk and incidence of rheumatic AEs associated with biologic therapy in CRSwNP and summarize current reported management strategies.

Methods: A protocol was registered in PROSPERO [CRD42024525663]. A search was conducted in four electronic databases: Medline (Ovid), Embase, Scopus, and Cochrane CENTRAL from inception until January 4, 2024. Two reviewers independently screened citations and extracted data. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tool. Data were pooled using a random effects model to calculate overall incidence and relative risk.

Results: Twenty-one studies met the final inclusion criteria, totaling 3434 patients of which 2763 (80%) received either dupilumab (n = 2257; 82%), mepolizumab (n = 372; 13%), or omalizumab (n = 134; 5%) for treatment of CRSwNP. The overall incidence rate for any on-treatment rheumatic AE was 0.05 per person-year (95% CI, 0.03-0.09, I2 = 75%). Biologic therapy increased the risk of developing a rheumatic AE (RR = 2.53; 95% CI, 1.29-4.94) compared with placebo. The most frequently reported rheumatic AE was arthralgia or joint pain (n = 94; 95%), followed by lupus-like syndrome or lupus erythematosus-like reaction (n = 2; 2.5%). Discontinuation of treatment was the most common intervention (n = 21, 39%).

Conclusion: Biologic therapy increases the risk of rheumatic AEs in CRSwNP patients by over twofold. Healthcare providers should remain vigilant in monitoring rheumatic AEs and apply appropriate management strategies on a case-by-case basis.

Keywords: adverse drug reaction; biologic therapy; drug‐related side effects; meta‐analysis; rhinosinusitis; systematic review.

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References

REFERENCES

    1. Khan A, Vandeplas G, Huynh TMT, et al. The Global Allergy and Asthma European Network (GALEN rhinosinusitis cohort: a large European cross‐sectional study of chronic rhinosinusitis patients with and without nasal polyps. Rhinology. 2019;57(1):32‐42. doi:10.4193/Rhin17.255
    1. DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2017;127(3):550‐555. doi:10.1002/lary.26391
    1. Calus L, Van Bruaene N, Bosteels C, et al. Twelve‐year follow‐up study after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis. Clin Transl Allergy. 2019;9:30. doi:10.1186/s13601‐019–0269‐4
    1. Tokunaga T, Sakashita M, Haruna T, et al. Novel scoring system and algorithm for classifying chronic rhinosinusitis: the JESREC Study. Allergy. 2015;70(8):995‐1003. doi:10.1111/all.12644
    1. Thamboo A, Kilty S, Witterick I, et al. Canadian Rhinology Working Group consensus statement: biologic therapies for chronic rhinosinusitis. J Otolaryngol—Head Neck Surg. 2021;50(1):15. doi:10.1186/s40463‐021‐00493‐2

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