Treatment of eosinophilic otitis media with pegylated interferon-α 2a and 2b

Brian A. Neff, Stephen G. Voss, Matthew L. Carlson, Erin K. O'Brien, Joseph H. Butterfield

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective/Hypothesis: Eosinophilic otitis media (EOM) is a variant of chronic otitis media that is characterized by the development of thick mucoid middle ear effusion, adult onset bronchial asthma, sinonasal polyposis, and aspirin sensitivity. EOM is typically refractory to corticosteroid therapy and surgical intervention. Pegylated interferon (PEG-IFN) has effectively treated hypereosinophilic syndrome in clinical trials; however, the efficacy of this medication for EOM treatment remains undefined. Study Design: Retrospective, case series, tertiary academic center. Methods: A retrospective chart review was performed on EOM patients from 2008-2014. A total of 32 patients met the clinical criteria for EOM according to established diagnostic guidelines. Outcomes of all patients with severe, refractory EOM who initiated PEG-IFN therapy are reported. Results: Eight patients were treated with pegylated interferon-α 2a or 2b for refractory EOM. Half of the patients had significant side effects with interferon treatment. Three of these were able to continue at a reduced dosage without side effect reoccurrence, and one patient stopped the medication permanently. Four of eight (50%) patients had a complete clinical response with total resolution of otorrhea and normalization of middle ear mucosa, and were able to discontinue corticosteroid treatment. Two patients attempted to stop PEG-IFN therapy after prolonged symptom remission and had recurrent otorrhea. Both patients had symptom resolution after PEG-IFN reinitiation. Conclusions: These data demonstrate that pegylated interferon-α 2a and 2b therapy may benefit patients with severe, refractory EOM. Further larger studies with long-term follow-up are required to validate these early but promising results.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - 2016

Fingerprint

Otitis Media
Interferons
Therapeutics
Adrenal Cortex Hormones
Hypereosinophilic Syndrome
Otitis Media with Effusion
Middle Ear
Aspirin
Mucous Membrane
Asthma
Retrospective Studies
Clinical Trials
Guidelines

Keywords

  • Allergic otitis media
  • Asthma exacerbated respiratory disease
  • Chronic suppurative otitis media
  • Eosinophilic otitis media
  • Interferon-α 2a
  • Interferon-α 2b
  • Nasal polyposis
  • PEG-intron
  • Pegasys

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Neff, B. A., Voss, S. G., Carlson, M. L., O'Brien, E. K., & Butterfield, J. H. (Accepted/In press). Treatment of eosinophilic otitis media with pegylated interferon-α 2a and 2b. Laryngoscope. https://doi.org/10.1002/lary.26303

Treatment of eosinophilic otitis media with pegylated interferon-α 2a and 2b. / Neff, Brian A.; Voss, Stephen G.; Carlson, Matthew L.; O'Brien, Erin K.; Butterfield, Joseph H.

In: Laryngoscope, 2016.

Research output: Contribution to journalArticle

Neff, Brian A. ; Voss, Stephen G. ; Carlson, Matthew L. ; O'Brien, Erin K. ; Butterfield, Joseph H. / Treatment of eosinophilic otitis media with pegylated interferon-α 2a and 2b. In: Laryngoscope. 2016.
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abstract = "Objective/Hypothesis: Eosinophilic otitis media (EOM) is a variant of chronic otitis media that is characterized by the development of thick mucoid middle ear effusion, adult onset bronchial asthma, sinonasal polyposis, and aspirin sensitivity. EOM is typically refractory to corticosteroid therapy and surgical intervention. Pegylated interferon (PEG-IFN) has effectively treated hypereosinophilic syndrome in clinical trials; however, the efficacy of this medication for EOM treatment remains undefined. Study Design: Retrospective, case series, tertiary academic center. Methods: A retrospective chart review was performed on EOM patients from 2008-2014. A total of 32 patients met the clinical criteria for EOM according to established diagnostic guidelines. Outcomes of all patients with severe, refractory EOM who initiated PEG-IFN therapy are reported. Results: Eight patients were treated with pegylated interferon-α 2a or 2b for refractory EOM. Half of the patients had significant side effects with interferon treatment. Three of these were able to continue at a reduced dosage without side effect reoccurrence, and one patient stopped the medication permanently. Four of eight (50{\%}) patients had a complete clinical response with total resolution of otorrhea and normalization of middle ear mucosa, and were able to discontinue corticosteroid treatment. Two patients attempted to stop PEG-IFN therapy after prolonged symptom remission and had recurrent otorrhea. Both patients had symptom resolution after PEG-IFN reinitiation. Conclusions: These data demonstrate that pegylated interferon-α 2a and 2b therapy may benefit patients with severe, refractory EOM. Further larger studies with long-term follow-up are required to validate these early but promising results.",
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