Dupilumab for chronic rhinosinusitis with nasal polyps: real-life retrospective 12-month effectiveness data*

Background: Dupilumab, an IL-4/13 receptor inhibitor, is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP). Methodology: We evaluated the effectiveness and safety of dupilumab for CRSwNP based on retrospective 12-month follow-up data of 41 patients. We analysed nasal endoscopy scores, patient-reported outcome measures (PROMs), 12-item Sniffin’-Sticks odor identification test (SSIT-12), total serum IgE, serum Eosinophilic Cationic Protein (ECP), and total blood eosinophil count (BEC). We performed statistical analysis using non-parametric ANOVA-type models and Spearman’s correlation. Results: At month 1, endoscopy scores, PROMs and SSIT-12 showed meaningful improvements that were maintained until month 12. Initial elevations in both median ECP and BECs returned to near baseline levels by month 12. The percentage of patients with BEC ≥0.6 remained increased at month 12 (42.1%) compared to baseline (19.5%). Total serum IgE levels decreased progressively and correlated with nasal polyp scores at month 12. “Adequate response” was reached in 86.8% of our cohort. Conclusions: Our data suggest that dupilumab is effective for the treatment of CRSwNP. The potential for short-and long-term BEC elevations in some CRSwNP patients should be carefully monitored.