Characteristics of cases dupilumab was introduced for postoperative recurrence of chronic rhinosinusitis with nasal polyps: A single-center study

Abstract

We report a case of chronic rhinosinusitis with nasal polyps (CRSwNP) that recurred after endoscopic nasal sinus surgery (ESS), resulting in postoperative recurrence, persistent nasal congestion, and olfactory dysfunction. Dupilumab—an anti-interleukin (IL)-4/13 monoclonal antibody (mAb)—is a promising therapeutic agent for such cases. We investigated the initiation and therapeutic effects of dupilumab in 30 patients with postoperative CRSwNP recurrence between July 2020 and June 2024, for whom dupilumab was considered appropriate. Among the 27 patients observed for more than six months, 17 underwent dupilumab treatment, 10 did not, and two of them opted for surgery during the follow-up period. In the dupilumab-treated group, the mean observation period was 31.1 months. Significant improvements were observed in the nasal polyp, nasal congestion, anosmia, postnasal drip, and self-administered odor question, as well as Lund-Mackay computed tomography score, at both 24 weeks and the final visit. Furthermore, dupilumab was associated with only minor complications and led to a reduction in the number of patients requiring oral corticosteroid therapy. In conclusion, dupilumab was highly effective improving both subjective symptoms and objective findings in patients with severe CRSwNP that recurred after ESS and may reduce dependence on systemic steroid. A literature review of related adverse events was also conducted.