Clinical efficacy of omalizumab combined with endoscopic sinus surgery in the treatment of chronic rhinosinusitis with nasal polyps complicated with asthma

Objective To investigate the clinical efficacy and safety of omalizumab combined with endoscopic sinus surgery in the treatment of chronic sinusitis with nasal polyps (CRSwNP) complicated with asthma.Methods The clinical data of 42 patients with CRSwNP complicated with asthma who underwent nasal endoscopic surgery were collected. Among them, 22 patients were treated with mometasone furoate nasal spray and normal sea salt as the control group; On the basis of the treatment of the control group, 20 patients were given omalizumab subcutaneous injection as the experimental group. The two groups were treated for 24 weeks. VAS score, SNOT-22 score, Lund Kennedy score of nasal endoscopy, Lund Mackay CT Score of nasal sinus, asthma control test (ACT) score, percentage and absolute value of eosinophils, tIgE and FEV1% pred were compared between the two groups, and the occurrence of adverse drug reactions and recurrence of nasal polyps were counted.Results In the intra group comparison, the VAS score, SNOT-22 score, Lund Kennedy score, Lund Mackay CT Score of the experimental group and the control group were significantly improved after 24 weeks of treatment, and the difference was statistically significant (P < 0.05); However, the percentage and absolute value of eosinophils in the experimental group treated with omalizumab were significantly lower than those before, while the act score, total IgE and FEV1% pred were significantly higher, and the difference was statistically significant (P < 0.05); There was no statistical difference in the changes of these indicators in the control group (P > 0.05); In the comparison between groups: the changes of various indicators before and after treatment in the two groups were compared. The subjective symptom indicators and objective indicators in the experimental group with omalizumab were significantly improved compared with those in the control group, and the difference was statistically significant (P < 0.05); The recurrence rates of the experimental group and the control group were 5% (1 / 20) and 31.8% (7 / 22), respectively, and the difference was statistically significant (P < 0.05); The incidence of adverse reactions of omalizumab was 15% (3 / 20), and all of them were mild adverse reactions.Conclusion Omalizumab combined with nasal endoscopic surgery in the treatment of CRSwNP complicated with asthma has better clinical efficacy than surgery alone in the short term, and can effectively control the onset of asthma, and the incidence of adverse reactions is low, most of which are mild adverse reactions.