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Efficacy of Biologic Therapies for Eosinophilic Otitis Media: A Systematic Review and Meta-analysis

Do Hyeon Kim1, Kye Hoon Park1, Yun Jin Kang1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea.

The Journal of International Advanced Otology
|August 20, 2024
PubMed

Insights

Biologic treatments significantly improve symptoms and reduce eosinophil and IgE levels in eosinophilic otitis media. However, hearing thresholds did not show significant changes with these advanced therapies.

Area of Science:

  • Otolaryngology
  • Immunology
  • Allergy

Background:

  • Eosinophilic otitis media (EOM) is a rare, viscous middle ear disease often associated with asthma and chronic rhinosinusitis.
  • Its pathophysiology is not fully understood, and it can be refractory to conventional treatments like steroids.
  • EOM is increasingly recognized as a type 2 inflammatory condition requiring targeted therapies.

Approach:

  • A systematic review and meta-analysis was conducted, searching major databases up to September 2023.
  • Data on clinical outcomes, hearing thresholds, and biomarkers (serum eosinophils, IgE) before and after biologic treatment were analyzed.
  • The study compared the efficacy of biologic treatments against control groups and evaluated specific agents like dupilumab.

Key Points:

  • Biologic treatments led to significant improvements in subjective otitis media-related scores compared to controls.
  • Serum eosinophil counts and immunoglobulin E (IgE) levels were significantly reduced after 6-12 months of biologic therapy.
  • No significant changes were observed in hearing thresholds or air-bone gaps following biologic interventions.

Conclusions:

  • Biologic therapies offer a promising treatment avenue for eosinophilic otitis media, improving patient-reported outcomes and key inflammatory markers.
  • While effective for symptoms and biomarkers, biologics do not appear to restore hearing thresholds in EOM patients.
  • Further randomized controlled trials are necessary to solidify the role of biologics in managing refractory EOM and optimize treatment strategies.

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