Comparative real‐world outcomes of dupilumab versus endoscopic sinus surgery in the treatment of severe CRSwNP patients

• Published in: Clinical otolaryngology 2024-07, Vol.49 (4), p.481-489
• Main Authors: De Corso, Eugenio, Porru, Davide Paolo, Corbò, Marco, Montuori, Claudio, De Maio, Gabriele, Mastrapasqua, Rodolfo Francesco, Panfili, Marco, Spanu, Camilla, Di Bella, Giuseppe Alberto, D'Agostino, Giuseppe, Rizzuti, Alberta, Passali, Giulio Cesare, Galli, Jacopo
• Format: Article
• Language: English
• Subjects: Administration, Intranasal; Adult; Antibodies, Monoclonal, Humanized - therapeutic use; biologics; Chronic Disease; chronic rhinosinusitis; Comparative studies; Corticoids; Corticosteroids; Cytology; dupilumab; Endoscopy; Eosinophilia; ESS; Female; Humans; IL‐4; Male; Middle Aged; nasal polyps; Nasal Polyps - complications; Nasal Polyps - drug therapy; Nasal Polyps - surgery; Nose; Otolaryngology; Patients; Polyps; Retrospective Studies; Rhinitis - complications; Rhinitis - drug therapy; Rhinitis - surgery; Rhinosinusitis; Severity of Illness Index; Sinusitis - complications; Sinusitis - drug therapy; Sinusitis - surgery; Smell; Steroids; Surgery; Treatment Outcome
• ISSN: 1749-4478; 1749-4486; 1749-4486
• DOI: 10.1111/coa.14172

Introduction Management of severe chronic rhinosinusitis with nasal polyps (CRSwNP) has changed significantly in recent years, with different treatments now available including biologics and endoscopic sinus surgery (ESS), although there are still few comparative studies. We aimed to compare 1‐year outcomes of patients with severe CRSwNP treated with dupilumab or ESS plus intranasal corticosteroids (INCS). Methods In this retrospective, real‐life, observational, cohort study, we enrolled 101 patients with severe CRSwNP who were treated with INCS and either ESS (n = 49) or dupilumab (n = 52). The following outcomes were considered: nasal polyp score (NPS), Sino Nasal Outcome Test‐22 (SNOT‐22), visual analogue scale (VAS) for specific symptoms, Sniffin' Sticks identification test (SSIT), need for oral corticosteroids (OCS) and local eosinophilia detected by nasal cytology. Results ΔNPS was significantly higher in the surgery group up to 12 months when the difference with dupilumab group was no longer significant (ΔNPS: 4 vs. 4.1). ΔVAS rhinorrhoea, ΔVAS smell and ΔSNOT‐22 were significantly higher in the dupilumab group at 12 months (p