The purpose of this study is to determine if treatment with the anti-IgE antibody, Xolair (omalizumab), will improve objective and subjective evidence of chronic sinusitis.
At its most basic level, sinusitis is defined as an inflammation of the lining membrane of the paranasal sinuses. Sinusitis affects all age groups, including 17% of people above the age of 65 years. On the basis of national population surveys and insurance-reimbursement claims, sinusitis is one of the most common health problems in the U.S. Thus, each year, billions of dollars are spent on direct medical costs for the treatment of this enigmatic illness. Despite the enormous cost of the problem, there are no definite studies of treatment and management. There are some data indicating that intranasal steroids are effective, and recently Nasonex was approved for the treatment of nasal polyps. All other treatments are empirically based. There is evidence that IgE antibodies play a role in chronic sinusitis. The investigators have shown that total IgE levels correlate with the severity of sinusitis, as assessed by CT scan. Staphylococcus enterotoxins cause local increases in total IgE in over 50% of nasal polyp patients. Allergies occur more frequently in patients with chronic sinusitis than in the general population. Elevations in total IgE have been shown to occur in patients with allergic fungal sinusitis and the levels of total IgE decrease with successful treatment. Thus, the investigators speculate that IgE contributes significantly to the pathogenesis of chronic sinusitis. The purpose of this study is to determine if treatment with the anti-IgE antibody, Xolair, will improve objective and subjective evidence of chronic sinusitis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
14
given subcutaneously oce or twice monthly depending on dose
The University of Chicago
Chicago, Illinois, United States
Mucosal thickness on CT scan
Time frame: after 6 months of treatment
Rhinosinusitis Disability Index (RSDI)recorded monthly
Time frame: 6 months
A specific quality of life (QOL) measure, Sino-Nasal Outcome Test (SNOT 20)recorded monthly
Time frame: 6 months
A general health QOL measure (SF-36)
Time frame: 6 months
The number of sinusitis exacerbations requiring additional treatment
Time frame: 6 months
Nasal peak inspiratory flow
Time frame: 6 months
Symptoms of nasal discharge, nasal obstruction, facial pain and altered smell
Time frame: 6 months
Nasal lavage eosinophils
Time frame: 6 months
Nasal endoscopy score
Time frame: 6 months
The University of Pennsylvania Smell Identification Test (UPSIT)
Time frame: 6 months
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