CRSwNP and Dupilumab – Experiences after one year of clinical use at a university ENT clinic.

Introduction

In diseases such as bronchial asthma or atopic dermatitis, which are based on a type II inflammation, biologicals are part of the standard therapy. Since October 2019, the bilogical dupilumab has been approved as an add-on therapy for the treatment of severe chronic rhinosinusitis with nasal polyposis (CRSwNP). The aim of this study is to evaluate the acceptability, symptom development, and side effects after one year of clinical use.

Material and Methods

A total of 24 patients who received therapy with dupilumab between 07/2020 and 10/2021 were included in the retrospective study. Demographic data, previous disease, and prior surgery were recorded. Endpoints were changes in SNOT-22 questionnaire, nasal polyp score (NPS), and odor testing (GT) using Sniffin' Sticks.

Results

Initially, the SNOT-22 yielded a mean score of 62.1 (n=18) out of a possible 110 points, the NPS was 5.1 (n=17), and the GT yielded 4.5 (n=17) correctly reported odors out of a possible 12. In the three- to nine-month follow-up after therapy initiation, the mean SNOT-22 scores reduced highly significantly to 15.7 (n=7, p<0.01), NPS to 1.3 (n=7, p<0.01), and GT improved significantly to 10 (n=5, p<0.05). 62.5% of patients showed bronchial asthma and 33.3% a NSAID intolerance. Adverse side effects were not reported.

Conclusion

The initial experience shows that dupilumab as an add-on therapy in patients with CRSwNP leads to a significant decrease in sinunasal symptoms and reduction of existing polyps, accompanied by a marked improvement in olfactory performance. Anamnestic evidence shows good applicability with a low side effect profile.

Publikationsverlauf

Artikel online veröffentlicht:
24. Mai 2022