Dynamics of the clinical condition of patients with polypous rhinosinusitis during complex therapy with physical factors and dupilumab

Objective. Assessment of the dynamics of the clinical condition of patients with PRS during a course of complex use of low-intensity laser radiation and mesodiencephalic modulation against the background of genetically engineered biological therapy with dupilumab. Material and methods. The study was performed with the participation of 128 patients with polypous rhinosinusitis. All patients who took part in the study received basic therapy (BT) with mometasone 2 doses 2 times a day and daily twice-daily rinsing of the mucous membrane of the nasal cavity with saline. Using the method of simple fixed randomization, all patients were divided into 4 groups. The first group (control, n= 32) received only BT. Patients of the second group (comparison group 1, n = 32) additionally received dupilumab subcutaneously at a dose of 300 mg once every two weeks. The third group of patients (comparison group 2, n=32) received a course of low-intensity laser radiation (LILR) along with BT and dupilumab. In the fourth group (main, n=32), LILR and MDM therapy were additionally used against the background of dupilumab administration. Evaluation of clinical efficacy was based on the dynamics of nasal polyposis severity using the Lund-Mackay and Meltzer scales, the nasal congestion index and the SNOT-22 questionnaire for assessing the quality of life of patients with polypous rhinosinusitis. Results. The maximum regression of clinical manifestations of polypous rhinosinusitis was established in the group with BT supplemented with dupilumab and the complex use of low-intensity laser therapy and mesodiencephalic modulation. High therapeutic efficacy when using a complex of physiotherapeutic effects is due to the synergistic nature of the interaction of factors, manifested by the potentiation effect. The supra-additive effect is based on the multimodal impact of factors, various points of application of LILI (local action) and MDM (systemotropic action) and mechanisms of implementation of therapeutic activity. Conclusion. High efficiency of the complex application of low-intensity laser radiation and mesodiencephalic modulation against the background of the biological drug dupilumab in the treatment of patients with polypous rhinosinusitis has been established. The therapeutic effect of the complex application of physiotherapeutic methods is due to the potentiating effect of physical factors, which allows enhancing synergistic potencies in the mechanism of the therapeutic action of genetically engineered biological therapy.