D3.359 - Study of olfaction in patients with chronic rhinosinusitis with nasal polyposis undergoing Mepolizumab treatment

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammation of the nasal mucosa and paranasal sinuses that is progressive, prevalent, and associated with comorbidities. It has specific symptoms such as olfactory dysfunction (OD), which is present in 60-80% of cases and affects the quality of life (QoL). Currently, there are new advanced biological treatment options for CRSwNP, such as mepolizumab, which has shown efficacy in controlling the condition. The main objective was to evaluate the characteristics of OD, measured by olfactometry, in patients with CRSwNP treated with Mepolizumab.

Adults with CRSwNP and OD undergoing treatment with mepolizumab were included. The study of OD was performed using the visual analog scale (VAS) for loss of smell, loss of taste, and nasal obstruction. Olfactometry was performed with the BOT-8 (Barcelona Olfactory Test-8) and the olfactory threshold for rose. The abbreviated QOD-NS (Brief Questionnaire of Olfactory Disorders-Negative Statements) was used to assess olfactory-related QoL, and the SNOT-22 (Sinonasal Outcome Test-22) was used for QoL related to nasal symptoms. Statistical analysis was performed using STATA (StataCorp. TX, USA) with a significance level of p ≤ 0.05. Uni- and multivariate analyses were conducted to identify predictors of QoL.

Seven patients were included, during 2022-2023. The sample was predominantly female (57%) with a mean age of 56.7 years (range = 40-73), and no history of atopy. The presence of EREA (respiratory disease induced by anti-inflammatory drugs) was observed in 72%, with an average of 1.7 prior surgeries (range = 1-3). At baseline, 72% of patients were anosmic and 28% had severe hyposmia. After one year, 57% remained anosmic, 29% had mild hyposmia, and 14% were normosmic (p < 0.05). No significant differences were observed for taste, both in the VAS and in gustometry detection (92%). The initial mean QoL score on the SNOT-22 was 57.14 points, which improved to 38.14 points after one year (a difference of 19 points).

Olfactory dysfunction in patients with CRSwNP treated with mepolizumab, studied through olfactometry, shows improvements in olfactory parameters and QoL of the patients.