D2.130 - Dupilumab for asthma and chronic rhinosinusitis with or without nasal polyps : A Multi-Timepoint Real-World Analysis

Patients with comorbid asthma and chronic rhinosinusitis with or without nasal polyps (CRSwNP/CRSsNP) have a high disease burden. The real-world efficacy of dupilumab across multiple time points in this population remains to be fully described.

This real-world study enrolled 38 adult patients with asthma and CRSwNP/CRSsNP(Aug 2022–Aug 2025). Treatment comprised a 600mg dupilumab loading dose followed by 300mg every two weeks, alongside standard care. Outcomes were assessed at baseline, weeks 2, 4, 8, 16, 24, and 52. Primary endpoints were the Asthma Control Test (ACT) and the 22-item Sinonasal Outcome Test (SNOT-22). Secondary endpoints included the Asthma Quality of Life Questionnaire (AQLQ), Total Nasal Symptom Score (TNSS), rhinitis and olfactory Visual Analogue Scale (VAS), T&T olfactometry, blood eosinophil count (EOS), total IgE (tIgE), fractional exhaled nitric oxide (FeNO), forced expiratory volume in 1 second (FEV1%), and sinus CT Lund-Mackay score.

Significant improvements in patient-reported outcomes (SNOT-22, ACT, AQLQ, TNSS, rhinitis VAS, olfactory VAS) were observed from week 2 (all P<0.05) and sustained through week 52. At week 16, objective measures also improved: FEV1% increased (P<0.05), while FeNO and tIgE decreased (P<0.05). EOS count showed a transient rise at week 8 but later trended toward baseline. T&T olfactometry and Lund-Mackay scores significantly improved from baseline (P<0.05).

Dupilumab provides rapid (within 2 weeks) and sustained (up to 1 year) improvement in both subjective and objective outcomes in patients with asthma and chronic rhinosinusitis with or without nasal polyps, demonstrating its effectiveness in a real-world setting.