Page 21 - Portuguese Journal - SPORL - Vol 61. Nº2

Polyps 2020 (EPOS) and European Forum for an inclusion criterion in all clinical trials of
Research and Education in Allergy and Airway biologics 24-27 .
Diseases (EUFOREA) were reviewed, as were
2
the methods used in several clinical trials of Loss of smell score (LSS)
biologics in CRS with polyposis. The protocol Loss of smell is classified into four categories:
proposal includes: 0 – without loss of smell/normosmia, 1 – mild
• Evaluation of demographic and clinical data. hyposmia, 2 – moderate hyposmia, and 3
• Scales of evaluation and forms of application. – severe loss of smell/anosmia . In clinical
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• Criteria for treatment with dupilumab. trials and some specialized centers, this
• Suggested evaluations during follow-up assessment is performed using computer
and criteria for efficacy and suspension of software/records. As this approach is difficult
treatment. to implement in clinical practice, we propose
to apply this scale by enquiring about the
Results average severity of smell loss in the last week,
Clinical protocol as was performed in the screening phase of
Demographic and clinical data one of the clinical trials (Fig. 7). There are also
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Demographic and clinical data included age, psychophysical tests for smell assessment,
sex, assessment of the presence of asthma/ such as the 40-item smell test (The 40-item
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atopy/hypersensitivity to non-steroidal anti- University of Pennsylvania Smell Identification
inflammatory drugs (NSAIDs), smoking Test - UPSIT) (Fig. 7). However, since they are
status, number and type of previous sinonasal not available in all centers, we think that they
surgeries, number of cycles of systemic should be included only as complementary
corticosteroids in the previous two years, information.
nasal polyposis and rhinosinusitis severity
assessment scales, Lund-Mackay score Nasal Congestion Score (NCS)
assessment, quantification of eosinophils Daily assessment of nasal congestion is
in the peripheral blood, quantification of classified into four categories : 0 - without
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tissue eosinophils in patients who previously nasal congestion, 1 – mild nasal congestion,
underwent ESS, and dosage of total IgE. 2 - moderate nasal congestion, and 3 – severe
nasal congestion. Similar to the LSS, the
Evaluation scales proposal is to apply this scale by enquiring
Endoscopic Nasal Polyps Score (NPS) about the average nasal congestion in the last
The endoscopic NPS is a score between 0 and week (Table 1).
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4 for each side, according to the size of the
polyps, and is assessed by nasal endoscopy 22-item Sinonasal Outcome Test (SNOT-22)
(Fig. 6). The maximum score is 8 points . An This instrument measures the CRS-specific
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NPS ≥5 (and ≥2 for each side) was used as quality of life in the previous 2 weeks and

Figure 6
Endoscopic nasal polyps score

Volume 61 . Nº2 . June 2023 163