Bucher indirect treatment comparison of phase 3 trials with dupilumab and tezepelumab in chronic rhinosinusitis with nasal polyps.

BACKGROUND

Biologic therapies significantly affect clinical outcomes in patients with chronic rhinosinusitis with nasal polyps (CRSwNPs), including those with comorbid asthma. Tezepelumab and dupilumab act on upstream and downstream type 2 cytokine pathways, respectively.

OBJECTIVE

To indirectly compare the relative efficacy of dupilumab with tezepelumab based on phase 3 randomized controlled trials in CRSwNP, including those with comorbid asthma.

METHODS

A Bucher indirect head-to-head comparison of studies evaluating dupilumab and tezepelumab for relevant outcomes was performed.

RESULTS

Dupilumab and tezepelumab demonstrated comparable significant improvements in endoscopic-, radiologic-, olfactory-, and symptom-based outcomes in CRSwNP. Relative differences in hazard ratios for use of oral corticosteroids and/or surgery favored tezepelumab. However, no differences were observed when considering absolute values. Dupilumab demonstrated superiority in patients with comorbid asthma for symptom control.

CONCLUSION

Indirect treatment comparison revealed comparable overall clinical benefits of dupilumab and tezepelumab in CRSwNP. However, a prospective head-to-head randomized controlled trial would be needed to confirm their relative efficacy.