Efficacy of Dupilumab in the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP): a multicentric real-life study.

PURPOSE: Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with morbidity and impairment in quality of life. Lately, new biological drugs have been developed and approved for its treatment. Dupilumab was the first to be approved but long-term real-world results are still limited.

METHODS

This is a real-life, multicenter observational study assessing the effectiveness of dupilumab in patients with CRSwNP with a follow-up from 3 to 24 months. We focused on nasal polyps score (NPS), quality of life (SNOT-22), olfactory function and blood eosinophils trend. Moreover, results were stratified by previous surgery, comorbidities, and blood eosinophils and IgE levels at baseline.

RESULTS

We observed a significant decrease in NPS and SNOT-22 from baseline to all the follow-up sessions. Olfaction improved over time and a significant difference was observed between baseline and 12 and 18 months. At 12 months follow-up, NPS of patients who had undergone surgery was lower than NPS of naïve patients (p =.012). Surgery did not influence SNOT-22 or improvement of smell. Comorbidities did not affect the outcomes. Blood eosinophils increased from baseline, reaching a peak at 3 months and gradually decreasing to a value similar to baseline at 18 months. The level of blood eosinophils and total IgE at baseline did not influence the effect of the drug on NPS at 12 months. No major adverse events were observed.

CONCLUSION

Dupilumab was proven to be effective in terms of reduction of dimension of nasal polyps, improvement of quality of life and olfaction and no major adverse events were observed.