Comparison of alcohol-induced reactions in patients with chronic rhinosinusitis, nasal polyps and NSAIDs exacerbated respiratory disease (N-ERD) after dupilumab or aspirin desensitization

Introduction Alcohol-induced reactions have been described after alcohol consumption in patients with chronic rhinosinusitis, nasal polyps (CRSwNP) and NSAIDs exacerbated respiratory disease (N-ERD). Previously is unexplored about the extent to which aspirin desensitization or Th-2 biologics influence the severity of alcohol-induced reactions. In the following study, the severity of alcohol-induced reactions following treatment with dupilumab (anti IL-4/ IL13) or aspirin desensitization in N-ERD patients was investigated and compared.  

Methods Retrospective study. Patients with CRSwNP, asthma, N-ERD and positive history of alcohol-induced reactions who received dupilumab or aspirin desensitization. Controls received nasal corticosteroids only (1. aspirin desensitization group n=50, 29f, 21m, mv 49y; 2. dupilumab group n=55, 29f, 26m, mv 45y; 3. Controls n=55, 30f, 25m, mv 48y). VAS-scores after alcohol consumption before and 3 months after initiated treatment. Mann Whitney U test (p<0.05).

Results The type of alcohol was red wine 68%, beer 59%, sparkling wine or white wine 58% and liqueur 38%. VAS-scores rhinitis, nasal obstruction and sneezing were significantly reduced in the dupilumab group after alcohol consumption (p=0.00). According to the aspirin desensitization group, only the VAS-score nasal obstruction was significantly reduced (p=0.00) In the control group the rhinitis parameters differed not significantly.

Conclusions Dupilumab therapy has positive effects on alcohol-induced reactions in N-ERD atients. This aspect should be investigated in larger studies.

Conflict of Interest

The author declares that there is no conflict of interest.

Publication History

Article published online:
24 May 2022