Real-world-effectiveness of Dupilumab and Omalizumab in severe chronic rhinosinusitis with polyposis (CRSwNP)

Introduction CRSwNP is a heterogeneous disease, which is associated with type II inflammation in 80% of cases in this country. Three biologics are approved in Germany for the treatment of the severe form of CRSwNP. In this study, the effectiveness and tolerability of dupilumab and omalizumab in clinical use were investigated and compared.

Methods Adults with severe uncontrolled CRSwNP were treated with dupilumab (n=57) or omalizumab (n=22). The observation period was 12 months. Nasal polyp scores (NPS), quality of life (QoL, SNOT-22), and olfactory function (OF, Sniffin’ Sticks identification test) were examined initially (V1), after one (V2), after 6 (V3), and after 12 (V4) months. Results To date, 38/79 participants completed V4 (dupilumab n=27, omalizumab n=11). The dupilumab group showed a reduction in NPS (p<0.001), improvement in QoL (p<0.001) and OF (p≤0.005) at V2, V3 and V4. In the omalizumab group, V2, V3 and V4 showed a reduced NPS (p≤0.024). In V2 and V3, an improvement in QoL (p≤0.01) was demonstrated, but not for OF (p≥0.17). In V4, neither QoL nor OF was significantly improved. Due to inadequate response, 7 patients in the omalizumab group were switched to another biological. This was the case once in the dupilumab group, but here 3 patients had their therapy switched due to side effects.

Conclusion  A positive influence of omalizumab and dupilumab in add-on therapy in severe CRSwNP could be shown. Only dupilumab showed a significant improvement in olfaction. The good tolerability of both biologics could be confirmed.

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Artikel online veröffentlicht:
12. Mai 2023