Dados do Trabalho

Título

Effects of Benralizumab on Chronic Rhinosinusitis with Nasal Polyps: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Resumo

Introduction: Benralizumab is a humanized monoclonal antibody that binds to the alpha subunit of IL-5 receptor and induces apoptosis in eosinophils. In severe eosinophilic asthma, benralizumab significantly enhances lung function, reduces exacerbations and improves asthma control and health-related quality of life. However, the effects of benralizumab on severe chronic rhinosinusitis with nasal polyps (CRSwNP) remain uncertain. This study aimed to compare the efficacy and safety of benralizumab with placebo for the treatment of CRSwNP.

Methods: A systematic review was conducted using PubMed, EMBASE and Cochrane Library. We included placebo-controlled, randomized trials of benralizumab in adults (age ≥ 18) with severe CRSwNP. We estimated the mean differences (MDs) of the Sino-Nasal Outcome Test-22 (SNOT-22), Nasal Polyp Score (NPS) and computed tomography-derived Lund-Mackay score (LMS). We also assessed the risk ratio (RR) of any adverse events (AEs). Statistical analysis was performed using Review Manager (RevMan) version 5.4.1. We estimated effects measures with the random-effects model.

Results: A total of 4 studies and 624 patients were included, of whom 338 (54.2%) received benralizumab. Benralizumab significantly reduced SNOT-22 (MD -5.14; 95% CI –9.07, -1.21; p = 0.01; I² = 0%) and NPS (MD -0.56; 95% CI -0.73, -0.39; p < 0.00001; I² = 7%). There was no significant change between groups in LMS (MD -1.32; 95% CI -2.91, 0.27; p = 0.10; I² = 74%) and in the risk of any adverse events (RR 0.99; 95% CI 0.91, 1.08; p = 0.85; I² = 0%).

Conclusion: Benralizumab considerably improved the extension and severity of nasal polyposis, symptoms and chronic rhinosinusitis-related quality of life in adult patients with severe CRSwNP, with no difference in any adverse events. These results underline the effectiveness of benralizumab in CRSwNP. However, further studies are necessary to evaluate long-term efficacy and security outcomes.