Evaluation of the effectiveness and side effect profile in elderly patients with CRSwNP receiving dupilumab therapy

Introduction Biologica are a highly effective treatment options for severe chronic rhinosinusitis with nasal polyposis (CRSwNP). Little is known about CRSwNP in elderly patients. In the CRSwNP phase 3 study of dupilumab, the maximum age of the patients was 61 years. The aim of this prospective study was to investigate the effectiveness of rhinonasal parameters and the side effect profile in CRSwNP patients after 6 months of dupilumab therapy.

Methods 48 patients with severe uncontrolled CRSwNP and age ≥ 65 years (Ø 70 years; min 65 years; max 83 years; 22 female, 26 male) were included. The frequency of asthma, ASA intolerance, the frequency of previous NNH surgeries and ASS deactivation were evaluated. The nasal polyposis (NP) score and the sinonasal outcome test (SNOT)-22 were evaluated before and after 6 months of therapy. The frequency of self-application and side effects during dupilumab therapy were recorded.

Results Asthma was present in 80% of the cases, ASS intolerance in 44%, NNH-OPs MW 3.2 and ASS deactivation had occurred in 14% of the patients. The NP score and the SNOT-22 were significantly reduced after 6 months of dupilumab therapy (NP score initially mean 4.43, after 6 months 1.47; p< 0.001; SNOT-22 initially mean 53,41, after 6 months 20.24, p<  0.001). Dupilumab injections were self-administered in 98% of cases. Joint pain (6%) and skin reddening (4%) were reported as side effects during dupilumab therapy.

Conclusions Dupilumab therapy is a highly effective therapy with few side effects in elderly patients with severe CRSwNP.

Publication History

Article published online:
12 May 2023