Platelet-to-Lymphocyte Ratio Might Predict Response to Dupilumab in Patients with Chronic Rhinosinusitis with Nasal Polyps

by Linda Kossoff  •

CLINICAL QUESTION

What is the relevance of inflammatory markers regarding therapy response to dupilumab in patients with chronic rhinosinusitis with nasal polyps (CRSwNP)?

BOTTOM LINE

Platelet-to-lymphocyte ratio (PLR) might have a predictive value in CRSwNP patients in terms of treatment response to dupilumab, particularly PLR above 131.2.

BACKGROUND: Recurrent disease in patients with cCRSwNP is a challenge, and efforts have been made to identify predictive inflammatory biomarkers. Dupilumab has been proven effective in treating patients with CRSwNP. However, some patients are non- or partial responders, highlighting the potential relevance of inflammatory markers in treatment response.

STUDY DESIGN: Retrospective study.

SETTING: Department of Otorhinolaryn-gology and Head and Neck Surgery, Medical University of Vienna, WähringerGürtel 18-20, 1090, Vienna, Austria.

SYNOPSIS: Researchers identified 65 patients (64.6% male, mean age 51.3 years, 95.4% Caucasian) with primary CRSwNP who were treated with dupilumab (biweekly 300 mg) between January 1, 2020, and August 31, 2021, at a tertiary healthcare center. Subjects had available pre-treatment markers for analysis of pre-treatment peripheral blood values. Patients received follow-up after one, two, and six months. The mean pre-treatment NPS of the cohort was 4.3 + 1.9, indicating mild disease in most patients. Pre-treatment neutrophil-to-lymphocyte ratio (NLR) and PLR values were associated with the outcome. The mean pre- and post-treatment total NPS values were 4.3 + 1.9 and 1.2 + 1.6, respectively. Total improvement (NPS 0) was observed in 32 patients (49.2%). In a multivariable analysis, researchers found that high PLR (>131.2) was independently associated with a 3.9-fold higher probability of reaching the NPS value of 0. High NLR (> 1.9) did not significantly associate with the outcome. The authors state that the exact prognostic value of PLR for patients with CRSwNP warrants further investigation in a large-scale cohort. Study limitations included its retrospective nature and limited cohort size.

CITATION: Brkic FF, Liu DT, Rücklinger I, et al. Platelet-to-lymphocyte ratio might predict the response to dupilumab treatment for patients with nasal polyposis. J Otolaryngol Head Neck Surg. 2023;52:75.