Professor Rhinology University of Queensland Centre for Clinical Research, Australia
Background: LYR-210 is an implantable matrix designed to release mometasone furoate for 24 weeks onto inflamed sinonasal mucosa in chronic rhinosinusitis (CRS) patients. LYR-210 demonstrated dose-dependent and significant improvement in the SNOT-22 total score compared to control, with all LYR-210 (7500µg)-treated patients achieving the 8.9-point minimal clinically important difference (MCID) at week 24. To further assess the impact of LYR-210 on SNOT-22 in the LANTERN study, the change from baseline (CFBL) and proportion of responders for each subdomain were evaluated.
Methods: Surgically naïve adults with moderate-to-severe CRS who failed previous medical management enrolled in a multicenter, randomized, controlled (LANTERN) study. 23 patients underwent sham-procedure (control); 21 and 23 patients received bilateral administration of LYR-210 (7500µg) and LYR-210 (2500µg), respectively. MCID values for the rhinologic, extranasal rhinologic, ear/facial, psychological, and sleep domain scores are 3.8, 2.4, 3.2, 3.9, and 2.9, respectively (Chowdhury, 2017). CFBL and MCID response in each SNOT-22 subdomain were analyzed using ANCOVA and logistic regression models, respectively.
Results:LYR-210 demonstrated dose-dependent symptom improvement with LYR-210 (7500µg) achieving statistical significance (p < 0.05) in each SNOT-22 subdomain compared to control at week 24. More LYR-210 (7500µg)-treated patients achieved the MCID vs. control in the rhinologic (90% vs 65%), extranasal rhinologic (71% vs 52%), ear/facial (80% vs 48%), psychological (90% vs 78%), and sleep (90% vs 61%) domains at week 24.
Conclusions: As LYR-210 demonstrated global symptom improvement based on SNOT-22 in CRS, it may be a promising long-acting sinonasal treatment.