We investigated the cases of 9 patients with severe
asthma treated with intravenous
reslizumab at a dose of 3 mg per 1 kg of weight with regularity once in 4 weeks. The presence of CRS with
polyps was revealed in 7 of 9 patients, SCT scanning of the paranasal sinuses indicated changes in all the patients, 2 patients had symptoms of chronic non-
allergic rhinitis (NARES).The treatment effectiveness control was carried out after 6 months from the beginning of the treatment by the dynamics of nasal symptoms (SNOT-22), endoscopic image of the nose, total
polyp score (TPS), changes in the SCT of the paranasal sinuses on the Lund-Mackay scale, rhinocytogram, the content of eosinophilic cationic
protein in the blood, the level of systemic
eosinophilia. The effectiveness of
asthma control was assessed by the reduction of the frequency of
asthma exacerbations, the need for systemic
corticosteroids, spirometry data and
Asthma Control Test (ACT) results. Along with a marked improvement in
asthma control, 8 out of 9 patients displayed clinical, endoscopic, radiological signs of weakening of nasal symptoms. More significant improvement in
asthma control was achieved in patients having CRS with
polyps. In the group of patients having CRS with
polyps, it was possible to detect anamnestic presence of NARES symptoms in the early stages of the disease. This indicates that NARES can be a precursor to the development of eosinophilic, non-
IgE-induced
asthma and nasal polyps.
CONCLUSION: Treatment with
reslizumab in patients with eosinophilic
asthma and concomitant CRS with
polyps and chronic non-
allergic rhinitis (NARES) leads not only to improved control of
asthma symptoms, but also to a significant regression of nasal symptoms.