May 2022

ENT

EFFICACY OF AN ORAL CRTH2 ANTAGONIST IN THE TREATMENT OF CHRONIC RHINOSINUSITIS

Featuring: ​ Robert C Kern, MD, Bruce K Tan, MD​, David B. Conley, MD
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Read the full study here.


Abstract
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease of the upper airways. AZD1981 is a selective antagonist of chemoattractant receptor-homologous molecule expressed on T helper type 2 and other type 2 cells, including innate lymphoid cells type 2, eosinophils, and basophils.

Objective: To evaluate the efficacy of AZD1981 in reducing nasal polyp size when added to intranasal corticosteroids in adult patients with CRSwNP.

Methods: Eighty-one subjects (18-70 years of age) with CRSwNP were recruited and screened for trial eligibility from allergy and otolaryngology clinics from a single tertiary care site between June 2016 and August 2019. Eligible patients were randomized in a double-blind fashion to receive either AZD1981 (n = 22) or placebo (n = 21) orally three times a day for 12 weeks, added to intranasal corticosteroids. The primary endpoint was a change in nasal polyp score (NPS) at 12 weeks. Secondary endpoints included improvement in sinus computed tomography using Lund Mackay scoring, symptoms using visual analog scale, quality of life using Sino Nasal Outcome Test-22, and the Brief Smell Identification Test.

Results: Forty-three patients met the inclusion criteria and were enrolled. At 12 weeks, there was no difference in NPS change in the AZD1981 arm (mean 0, standard error 0.34, n = 15) compared with placebo (mean 0.20, standard error 0.36, n = 17); mean difference -0.20 (95% confidence interval: -1.21, 0.81; p = .69). No significant differences were observed for Lund Mackay score, symptoms, quality of life, or smell test. AZD1981 was well tolerated except for one case of hypersensitivity reaction.
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Conclusion: In patients with CRSwNP, the addition of AZD1981 to intranasal corticosteroids did not change nasal polyp size, radiographic scores, symptoms, or disease-specific quality of life.


This abstract was originally published in Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology on March 6, 2022. ​
Robert C Kern, MD, chair of the department of Otolaryngology - Head and Neck Surgery, George A. Sisson, MD, and professor of Otolaryngology - Head and Neck Surgery and Allergy and Immunology in the Department of Medicine.
Bruce K Tan, MD​, associate professor of Otolaryngology - Head and Neck Surgery  and Allergy and Immunology in the Department of Medicine.
David B. Conley, MD, associate professor of Otolaryngology - Head and Neck Surgery at Northwestern University's Feinberg School of Medicine.

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