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. 2025 Jul;135(7):2267-2274.
doi: 10.1002/lary.32162. Epub 2025 Mar 28.

Dupilumab Monthly Dose De-Escalation Maintains Efficacy in CRSwNP: A Two-Year Real-World Study

Eugenio De Corso  1 , Claudio Montuori  2 , Gabriele De Maio  2 , Leandro Maria D'Auria  2 , Alberta Rizzuti  2 , Maria Clara Pacilli  2 , Giuseppe D'Agostino  2 , Rodolfo Mastrapasqua  3 , Dario Antonio Mele  1 , Jacopo Galli  1   2
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Dupilumab Monthly Dose De-Escalation Maintains Efficacy in CRSwNP: A Two-Year Real-World Study

Eugenio De Corso et al. Laryngoscope. 2025 Jul.

Abstract

Objective: The aim of this study was to evaluate if dupilumab interval dose de-escalation to every 4 weeks negatively impacts treatment outcomes in real-life practice for severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) during the first 2 years of treatment.

Methods: We enrolled 148 patients who completed 2 years of follow-up. We compared two homogenous groups in terms of severity: group A included 77 patients who never modified the interval of administration during follow-up; group B included 71 patients who extended the dosing interval to monthly administration. We compared the treatment outcomes and differences in safety.

Results: The monthly interval dose prolongation was started in 22/71 patients (30.99%) at 6 months, in 11/71 (15.48%) at 9 months, in 22/71 (30.99%) at 12 months, and in 16/71 (22.54%) at 18 months. The dose prolongation was to manage minor adverse events in 9 of 71 patients; persistent eosinophilia in 26/71 patients; specific request of patients who had confirmed sustained control as determined by the physician's assessment in 36/71 cases. Mean values of all outcomes of response to treatment (i.e., volume of polyps, nasal obstruction, quality of life, olfaction) significantly improved at 6, 12, and 24 months compared to baseline (p < 0.01) in both groups A and B. No significant differences were found comparing groups A and B for any of the outcomes examined over the 2 years of follow-up (p < 0.01).

Conclusion: These results suggest that extending to monthly dosing of dupilumab in real life does not negatively impact outcomes in patients with severe uncontrolled CRSwNP.

Keywords: biologics; chronic rhinosinusitis with nasal polyps; dose de‐escalation; dupilumab; real‐life.

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References

    1. R. R. Orlandi, T. T. Kingdom, T. L. Smith, et al., “International Consensus Statement on Allergy and Rhinology: Rhinosinusitis 2021,” International Forum of Allergy & Rhinology 11, no. 3 (2021): 213–739.
    1. M. S. Benninger, B. J. Ferguson, J. A. Hadley, et al., “Adult Chronic Rhinosinusitis: Definitions, Diagnosis, Epidemiology, and Pathophysiology,” Otolaryngology and Head and Neck Surgery 129, no. 3 (2003): S1–S32.
    1. W. J. Fokkens, V. J. Lund, C. Hopkins, et al., “European Position Paper on Rhinosinusitis and Nasal Polyps 2020,” Rhinology 58, no. Suppl S29 (2020): 1–464, https://doi.org/10.4193/Rhin20.600.
    1. P. Tomassen, G. Vandeplas, T. Van Zele, et al., “Inflammatory Endotypes of Chronic Rhinosinusitis Based on Cluster Analysis of Biomarkers,” Journal of Allergy and Clinical Immunology 137 (2016): 1449–1456.e1444.
    1. W. W. Stevens, A. T. Peters, B. K. Tan, et al., “Associations Between Inflammatory Endotypes and Clinical Presentations in Chronic Rhinosinusitis,” Journal of Allergy and Clinical Immunology. In Practice 7 (2019): 2812–2820.e2813.

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