Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Feb;45(1):28-38.
doi: 10.14639/0392-100X-N2841.

Role of body mass index as a predictor of dupilumab efficacy in patients with severe chronic rhinosinusitis with nasal polyps

Letizia Nitro  1 , Eugenio De Corso  2 , Marco Borin  3 , Alberto Maria Saibene  1 , Flavio Arnone  1 , Francesco Ferella  1 , Giulia Gramellini  3 , Alessandro Cantiani  4 , Gabriele De Maio  4 , Camilla Spanu  4 , Alberto Giulio Dragonetti  3 , Giovanni Felisati  1 , Carlotta Pipolo  1
Affiliations
Multicenter Study

Role of body mass index as a predictor of dupilumab efficacy in patients with severe chronic rhinosinusitis with nasal polyps

Letizia Nitro et al. Acta Otorhinolaryngol Ital. 2025 Feb.

Abstract

Objective: Response to dupilumab for chronic rhinosinusitis with nasal polyps, albeit almost always excellent, is still not predictable. Our study focuses on the role of body mass index (BMI) on the efficacy of dupilumab.

Methods: We present a retrospective multicentre study of 106 patients on dupilumab, stratified in 3 subgroups of BMI. The main therapeutic outcomes investigated were Nasal Polyp Score (NPS), Sino-Nasal-Outcome Test - 22 (SNOT-22), Sniffin' Sticks Identification test and visuo-analogical scale, and the different timing of response, according to De Corso et al. criteria.

Results: Dupilumab treatment led to a progressive improvement for all outcomes at all time points. Comparing the different metabolic subgroups, a late response in terms of decrease in NPS was observed only in 3 obese patients. A significant decrease was also found in SNOT-22 score at 6 and 12 months, which was less marked in overweight/obese patients.

Conclusions: Our study confirmed the efficacy of dupilumab in each BMI subgroup. However, the efficacy seems to follow different timing with respect to patients' BMI. Our data suggest that patients with a compromised metabolic state present more severe disease at baseline and a possibly delayed response to dupilumab.

Keywords: body mass index; chronic rhinosinusitis with nasal polyps; dupilumab; inflammasome; type-2 inflammation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Cover figure.
Cover figure.
A) Evidence of correlation at baseline between body mass index (BMI) and disease burden in chronic rhinosinusitis with nasal polyps (CRSwNP); B) Different time-related outcomes in Sino-Nasal-Outcome Test - 22 questionnaire score decrese based on BMI groups in patients with CRSwNP treated with dupilumab.
Figure 1.
Figure 1.
Decrease in SNOT-22 score for groups 1 (normal weight), 2 (overweight) and 3 (obese) at V6 and V12.
Figure 2.
Figure 2.
Bonferroni correction for SNOT-22 at V6.
Figure 3.
Figure 3.
Bonferroni correction for SNOT-22 at V12.
See this image and copyright information in PMC

References

    1. Fokkens WJ, Lund VJ, Hopkins C, et al. . Executive summary of EPOS 2020 including integrated care pathways. Rhinology 2020;58:82-111. https://doi.org/10.4193/Rhin20.601 10.4193/Rhin20.601 - DOI - PubMed
    1. Kato A. Immunopathology of chronic rhinosinusitis. Allergol Int 2015;64:121-130. https://doi.org/10.1016/j.alit.2014.12.006 10.1016/j.alit.2014.12.006 - DOI - PMC - PubMed
    1. Zhang N, Van Zele T, Perez-Novo C, et al. . Different types of T-effector cells orchestrate mucosal inflammation in chronic sinus disease. J Allergy Clin Immunol 2008;122:961-968. https://doi.org/10.1016/j.jaci.2008.07.008 10.1016/j.jaci.2008.07.008 - DOI - PubMed
    1. Lin H, Li Z, Lin D, et al. . Role of NLRP3 inflammasome in eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps. Inflammation 2016;39:2045-2052. https://doi.org/10.1007/s10753-016-0442-z 10.1007/s10753-016-0442-z - DOI - PubMed
    1. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000;894:I-XII, 1-253. - PubMed

Publication types

Substances