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Chronic Rhinosinusitis With Nasal PolypsDupi-PNSNCT06017427

Evaluation of Patient Satisfaction During Treatment With Dupilumab in Severe and Recurrent Nasosinusal Polyposis Despite Appropriate Medical and Surgical Treatment.

An observational study of Chronic Rhinosinusitis With Nasal Polyps, run by IHU Strasbourg at 1 site in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Chronic rhinosinusitis with nasal polyps (CRSwNP) or nasal polyposis is a frequent disease leading to a decreased quality of life. The validated course of treatment is firstly a medical one with saline irrigations and topical corticosteroids, followed by surgery (ethmoidectomy) if the medical treatment fails. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Chronic Rhinosinusitis With Nasal Polyps
What is being tested?
Questionnaires
How many people
32 participants
Where
1 siteFrance
Study dates
30 Aug 2023to 21 Sep 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients, men or women, of any age, having received treatment with Dupilumab for the indication of recurrent severe nasal polyposis despite surgery and appropriate medical treatment

Who may be able to join

  • Women and men over 18 years old
  • Suffering from severe and recurrent Chronic Rhinosinusitis with Nasal Polyps despite having benefited from the appropriate medical and surgical treatment.
  • CRSwNP diagnosis established on the basis of clinical presentation and patient interrogation by their referent ENT surgeon.
  • Patient treated with Dupilumab in the indication depicted in bullet point 2.
  • Patient having voiced their non-opposition to this research, having received clear and appropriate information.
  • Patient affiliated to the French Social Security.

Who cannot join

  • Patient having undergone endoscopic nasal surgery during their Dupilumab treatment.
  • Patient presenting exclusion criteria for Dupilumab treatment.
  • Patient suffering from immune deficit.
  • Patient suffering from vascularitis with nasal expression.
  • Patient whose autonomy has been reduced by a legal authority.
  • Patient unable to express their agreement to participate in this study.

Trial locations and contacts

1 site in 1 country.

France1 site
  • Hautepierre Hospital

    Strasbourg, 67000

Other trials in France

About this study

Chronic rhinosinusitis with nasal polyps (CRSwNP) or nasal polyposis is a frequent disease leading to a decreased quality of life. The validated course of treatment is firstly a medical one with saline irrigations and topical corticosteroids, followed by surgery (ethmoidectomy) if the medical treatment fails.

In many cases, CRSwNP becomes a recurrent disease despite maximal treatment as previously indicated and it becomes refractory, with a chronically reduced quality of life.

Read more

New treatments known as Biologics or Biotherapies in France such as Dupilumab are now available in situations of severe recurrent CRSwNP despite the appropriate treatment.

The goal of this study is to assess the clinical effectiveness of Dupilumab and patient satisfaction, in a cohort of french patients, focusing on the change in quality of life that is expected from said treatment, over a period of one year.

Patients will undergo 6 months of treatment with Dupilumab, the treatment will then be stopped for the next 6 months.

The primary judgment criteria will be the SNOT 22 score, measured before treatment, after 6 months of treatment, and 6 months after stopping treatment, over a telephonic conversation.

Read the detailed description

CRSwNP has existed for over 5000 years, it is a frequent disease, affecting 1 to 4 % of the general population, especially older men and is defined by inflammatory modification of the sinuses and nasal cavities with benign growths of the mucosa known as polyps. It leads to numerous symptoms (nasal blockage, anosmia, nasal dripping, fatigue, pain), which have important consequences in terms of quality of life, social interactions, and by the heavy costs that are brought by medical and surgical treatment.

It is a multifactorial disease for which physiopathology is not well established.

No definitive treatment exists. The appropriate course of treatment aims to control the disease, but not cure it, via topical corticosteroids application which can be facilitated by endoscopic surgery (polypectomy, ethmoidectomy).

Recurrence is frequent after surgery (40 %, 18 months after surgery), which leads to more surgeries that get more complicated and riskier each time.

CRSwNP is also an expensive disease (several thousands of euros per year for one patient), especially in cases of recurrence after surgical treatment. The indirect costs are also high with work absenteeism and decreased productivity making CRSwNP one of the 10 most costly diseases for US employers.

Dupilumab, a biologic treatment targeting the receptors of IL4 and IL13 which are major actors of the inflammatory reaction at hand in CRSwNP, has recently appeared on the market for treatment of severe recurrent CRSwNP despite the appropriate medical and surgical treatment, and has proved its efficacy in randomized clinical trials.

It is a very expensive treatment (1400 euros a month for one patient in France), which is why its clinical effectiveness in a real-life setting must be assessed.

Hypothesis : Dupilumab improves symptoms and quality of life in severe recurrent CRSwNP despite the appropriate medical and surgical treatment.

Objectives : To assess the effect of Dupilumab and patient satisfaction during treatment and after its discontinuation, on symptoms and quality of life in patients suffering from severe and recurrent CRSwNP despite having benefited from the appropriate medical and surgical treatment, in a French real-life cohort.

Being tested
Questionnaires
Keywords
CRSwNP, decreased quality of life, Nasal polyps, Rhinosinusitis, recurrent CRSwNP, severe CRSwNP
Medical subject headings
Nasal Polyps, Rhinosinusitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • QuestionnairesOther

    Submission of several questionnaires (Quality of Life and clinical scores) at three time points: before initiation of Dupilumab, after 6 months of Dupilumab treatment, and 6 months after stopping Dupilumab treatment

Study groups in NCT06017427
Study groupRoleWhat they receive
Patients suffering from severe recurrent CRSwNP and treated with DupilumabPatients suffering from severe recurrent CRSwNP despite having benefited from the appropriate medical and surgical treatment and treated with Dupilumab for 6 months
Receives: Other: Questionnaires

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Assessment of the global effect of Dupilumab 1 day before Dupilumab by the mean of the SNOT 22 score

    The SNOT22 score is a validated questionnaire for the assessment of symptoms of Chronic rhinosinusitis, ranging from 0 to 110. The more severe are the disease and its associated symptoms, the higher is the score

    Measured: 1 day before Dupilumab

  2. Assessment of the global effect of Dupilumab 6 months of Dupilumab treatment by the mean of the SNOT 22 score

    The SNOT22 score is a validated questionnaire for the assessment of symptoms of Chronic rhinosinusitis, ranging from 0 to 110. The more severe are the disease and its associated symptoms, the higher is the score

    Measured: 6 months of Dupilumab treatment

  3. Assessment of the global effect of Dupilumab 6 months after stopping the treatment by the mean of the SNOT 22 score

    The SNOT22 score is a validated questionnaire for the assessment of symptoms of Chronic rhinosinusitis, ranging from 0 to 110. The more severe are the disease and its associated symptoms, the higher is the score

    Measured: 6 months after stopping Dupilumab treatment

Secondary outcomes (12)
  1. Assessment of the effect of Dupilumab on nasal obstruction by the mean of the Visual Analogic Scale for nasal obstruction

    Staging nasal obstruction level from 0 to 10. The more severe are the symptoms, the higher is the score

    Measured: 1 day before Dupilumab, at 6 months of Dupilumab treatment, and 6 months after stopping Dupilumab treatment

  2. Assessment of the effect of Dupilumab on the olfaction by the mean of the Visual Analogic Scale for Olfaction

    Staging olfaction levels from 0 to 10. The more severe are the symptoms, the higher is the score

    Measured: 1 day before Dupilumab, at 6 months of Dupilumab treatment, and 6 months after stopping Dupilumab treatment

  3. Assessment of the effect of Dupilumab on the severity of the nasal polyposis by the mean of the Nasal Polyp Score

    Endoscopic based score assessing the severity of nasal polyposis, 0 to 8. The more severe are the symptoms, the higher is the score

    Measured: 1 day before Dupilumab, at 6 months of Dupilumab treatment, and 6 months after stopping Dupilumab treatment

  4. Assessment of the effect of Dupilumab on the severity of the nasal polyposis on an iconographic level by the mean of the Lund McKay score

    CT-scan based score assessing the severity of nasal polyposis on an iconographic level, 0 to 24. The more severe are the symptoms, the higher is the score

    Measured: 1 day before the treatment initiation

  5. Assessment of the effect of Dupilumab on the quality of life by the mean of the EQ 5D 5L score

    Quality of life questionnaire associated with a Visual Analogic Scale ranging from 0 to 100. The more severe are the symptoms, the higher is the score

    Measured: 1 day before Dupilumab, at 6 months of Dupilumab treatment, and 6 months after stopping Dupilumab treatment

  6. Assessment of the effect of Dupilumab on the severity of the asthma by the mean of the ACT score

    Asthma control assessment score ranging from 5 to 25. The more severe are the symptoms, the higher is the score

    Measured: 1 day before Dupilumab, at 6 months of Dupilumab treatment, and 6 months after stopping Dupilumab treatment

  7. Assessment of the time to first improvement in sense of smell and nasal obstruction with Dupilumab

    Time between the beginning of treatment with Dupilumab and the first time a reduction in nasal obstruction and hyposmia was observed by the patient

    Measured: 1 day

  8. Time between stopping Dupilumab and possible deterioration of the sense of smell and nasal obstruction

    Time between the stopping of Dupilumab treatment and the first worsening of nasal obstruction and olfaction that was noted by the patient

    Measured: 1 day

  9. Evolution of a potential middle ear chronic inflammation during treatment

    rate of otitis appearance among the patients during their treatment with Dupilumab

    Measured: 1 day

  10. Necessity to use oral corticosteroids during or after Dupilumab treatment

    Rate of patients in need of corticosteroids during or after their treatment with Dupilumab

    Measured: 1 day

  11. Evolution to nasosinus superinfections during and after Dupilumab treatment

    Rate of nasosinus superinfections appearance observed during or after the treatment with Dupilumab

    Measured: 1 day

  12. Collect of adverse effects during Dupilumab treatment

    collect of adverse effects during Dupilumab treatment

    Measured: 1 day

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Aug 2023
  2. Study start30 Aug 2023
  3. Primary completion21 Sep 2023
  4. Study completion21 Sep 2023

Why it stopped: Number of inclusions sufficient for answering the main objective

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
32 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06017427
Sponsor's protocol ID
22-005
Acronym
Dupi-PNS
Status last verified
Jan 2024
First submitted
18 Jul 2023
Last updated
8 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Settipane RA, Peters AT, Chiu AG. Chapter 6: Nasal polyps. Am J Rhinol Allergy. 2013 May-Jun;27 Suppl 1:S20-5. doi: 10.2500/ajra.2013.27.3926.

    PubMed 23711034
  • Stjarne P, Odeback P, Stallberg B, Lundberg J, Olsson P. High costs and burden of illness in acute rhinosinusitis: real-life treatment patterns and outcomes in Swedish primary care. Prim Care Respir J. 2012 Jun;21(2):174-9; quiz 10p following 179. doi: 10.4104/pcrj.2012.00011.

    PubMed 22349918
  • Teul I, Zbislawski W, Baran S, Czerwinski F, Lorkowski J. Quality of life of patients with diseases of sinuses. J Physiol Pharmacol. 2007 Nov;58 Suppl 5(Pt 2):691-7.

    PubMed 18204184
  • Hopkins C, Browne JP, Slack R, Lund V, Topham J, Reeves B, Copley L, Brown P, van der Meulen J. The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Clin Otolaryngol. 2006 Oct;31(5):390-8. doi: 10.1111/j.1749-4486.2006.01275.x.

    PubMed 17014448
  • Leopold DA, Elkayam D, Messina JC, Kosik-Gonzalez C, Djupesland PG, Mahmoud RA. NAVIGATE II: Randomized, double-blind trial of the exhalation delivery system with fluticasone for nasal polyposis. J Allergy Clin Immunol. 2019 Jan;143(1):126-134.e5. doi: 10.1016/j.jaci.2018.06.010. Epub 2018 Jun 19.

    PubMed 29928924
  • Kobayashi Y, Yasuba H, Asako M, Yamamoto T, Takano H, Tomoda K, Kanda A, Iwai H. HFA-BDP Metered-Dose Inhaler Exhaled Through the Nose Improves Eosinophilic Chronic Rhinosinusitis With Bronchial Asthma: A Blinded, Placebo-Controlled Study. Front Immunol. 2018 Sep 25;9:2192. doi: 10.3389/fimmu.2018.02192. eCollection 2018.

    PubMed 30337921
  • Rice DH. Endoscopic sinus surgery. Otolaryngol Head Neck Surg. 1994 Jul;111(1):100-10. doi: 10.1177/019459989411100118. No abstract available.

    PubMed 8028915
  • Benninger MS, Sindwani R, Holy CE, Hopkins C. Impact of medically recalcitrant chronic rhinosinusitis on incidence of asthma. Int Forum Allergy Rhinol. 2016 Feb;6(2):124-9. doi: 10.1002/alr.21652. Epub 2015 Dec 1.

    PubMed 26624856
  • DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL. Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope. 2017 Mar;127(3):550-555. doi: 10.1002/lary.26391. Epub 2016 Nov 12.

    PubMed 27859303
  • Bhattacharyya N. Contemporary assessment of the disease burden of sinusitis. Am J Rhinol Allergy. 2009 Jul-Aug;23(4):392-5. doi: 10.2500/ajra.2009.23.3355.

    PubMed 19671253
  • Wahid NW, Smith R, Clark A, Salam M, Philpott CM. The socioeconomic cost of chronic rhinosinusitis study. Rhinology. 2020 Apr 1;58(2):112-125. doi: 10.4193/Rhin19.424.

    PubMed 32172284
  • Lourijsen ES, Fokkens WJ, Reitsma S. Direct and indirect costs of adult patients with chronic rhinosinusitis with nasal polyps. Rhinology. 2020 Jun 1;58(3):213-217. doi: 10.4193/Rhin19.468.

    PubMed 32415826
  • Bhattacharyya N. Assessing the additional disease burden of polyps in chronic rhinosinusitis. Ann Otol Rhinol Laryngol. 2009 Mar;118(3):185-9. doi: 10.1177/000348940911800305.

    PubMed 19374149
  • Goetzel RZ, Hawkins K, Ozminkowski RJ, Wang S. The health and productivity cost burden of the "top 10" physical and mental health conditions affecting six large U.S. employers in 1999. J Occup Environ Med. 2003 Jan;45(1):5-14. doi: 10.1097/00043764-200301000-00007.

    PubMed 12553174
  • Rudmik L. Economics of Chronic Rhinosinusitis. Curr Allergy Asthma Rep. 2017 Apr;17(4):20. doi: 10.1007/s11882-017-0690-5.

    PubMed 28337570

Questions about this trial

What is this clinical trial studying?

An observational study of Chronic Rhinosinusitis With Nasal Polyps, run by IHU Strasbourg at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 8 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Number of inclusions sufficient for answering the main objective). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Assessment of the global effect of Dupilumab 1 day before Dupilumab by the mean of the SNOT 22 score (time frame: 1 day before Dupilumab). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06017427, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jan 2024.

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