Page 24 - Portuguese Journal - SPORL - Vol 61. Nº2
P. 24
Table 3 angioedema occur within a few minutes or up
Visual analog scale for all symptoms (VAS for to seven days after the dupilumab injection.
total sinonasal symptom score)
The first dose should be monitored by an
otorhinolaryngologist.
- Helminthic infections: if patients contract a
helminthic infection while receiving treatment
with dupilumab and do not respond to the
antihelminthic treatment, dupilumab should
be discontinued until the infection is resolved.
Evaluation of the response to treatment:
Proposal for monitoring the efficacy/safety 2 consultation
nd
and criteria for efficacy and suspension of - Evaluation of the response at 16 weeks -
treatment with biologics Improvement required in at least one of the
following criteria:
- Reduction in the size of the polyps
• In at least 1 degree in nasal endoscopy (one
nasal cavity) or 2 points (right nasal cavity +
left): NPS - Endoscopic Nasal Polyps Score
- Reduction in the need for systemic
corticosteroids
• No need for systemic corticosteroids since
the start of the treatment
- Improvement in the quality of life
• Reduction ≥ 9 points in the SNOT-22
- Improved smell
• Disappearance of anosmia
- Reduction in nasal obstruction
• Improvement in the symptoms in the VAS:
reduction ≥ 2 points
Evaluation of the response to treatment:
rd
Evaluation of side effects: 1 consultation 3 consultation
st
- Evaluation at 4 weeks - - Evaluation of the response at 24 weeks -
The most frequent adverse reactions during Improvement required in at least one of the
treatment with dupilumab (the only treatment following criteria:
with a funded therapeutic indication in - Reduction in the size of the polyps
Portugal at the moment) are: reactions at the • In at least 1 degree in nasal endoscopy (one
injection site (erythema, edema, pruritus, and nasal cavity) or 2 points (right nasal cavity +
pain), conjunctivitis, allergic conjunctivitis, left): NPS - Endoscopic Nasal Polyps Score
arthralgia, oral herpes, and eosinophilia. Rare - Reduction in the need for systemic
cases of serum sickness reaction, serum corticosteroids
sickness-like reaction, anaphylactic reaction, • No need for systemic corticosteroids since
and ulcerative keratitis have been reported. the start of the treatment
- Improvement in the quality of life
Reasons for immediate suspension: • Reduction ≥ 9 points in the SNOT-22
- Systemic hypersensitivity reaction (immediate - Improved smell
or delayed): anaphylactic reaction and • Disappearance of anosmia
166 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery
