Real world data on the treatment of CRSwNP with dupilumab

Introduction Since 2019, monoclonal antibodies have been available as add-on therapy for refractory CRSwNP. Dupilumab was the first antibody to be approved in the clinic, so extensive experience has already been gained in this area.

Material and methods To start the therapy with dupilumab, the AeDA criteria were reviewed: Age > 18 years, diagnosis of severe CRSwNP, continuous use of intranasal coticosteroids, limitation of quality of life, insufficient control by systemic corticosteroids or paranasal sinus surgery. Diagnostically, the endoscopic polyp score was collected, the SNOT-22 was filled out by the patients, an olfactory test (sniffin’ sticks) and blood analysis (total IgE, eosinophils) were performed.

Results The analysis included 44 patients (23 women, 21 men; sex ratio: 1.1:1 age: median: 53 years + range: 30-83 years) who were followed for a period of 6 months. The endoscopic polyp score decreased from 4.73 (preintervention) to 3.03 (16 weeks) to 2.24 (6 months). The SNOT-22 score also decreased (pre: 61.02; 16 wk: 27.59; 6 mo: 24.36). The olfactory test and total IgE amount also showed significant improvements. 2 patients discontinued therapy and 4 were switched to another monoclonal antibody. Adverse events (local skin reactions, limb pain, eye burning) occurred in 8 patients. Summary The therapy of CRSwNP with dupilumab shows significant improvements in clinical outcome when the indication criteria are met. Long-term results must be awaited.

Publication History

Article published online:
12 May 2023