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. 2025 May 23;14(11):3654.
doi: 10.3390/jcm14113654.

Dupilumab-Induced Remission in Chronic Rhinosinusitis with Nasal Polyps and Comorbid Asthma: A 24-Month Study

Tomoko Tajiri  1 , Motohiko Suzuki  2 , Hirono Nishiyama  1 , Yoshiyuki Ozawa  3 , Yuki Amakusa  1 , Tatsuro Suzuki  1 , Keima Ito  1 , Yuta Mori  1 , Kensuke Fukumitsu  1 , Satoshi Fukuda  1 , Yoshihiro Kanemitsu  1 , Takehiro Uemura  1 , Hirotsugu Ohkubo  1 , Masaya Takemura  1 , Yutaka Ito  1 , Tetsuya Oguri  1 , Akio Niimi  1
Affiliations

Dupilumab-Induced Remission in Chronic Rhinosinusitis with Nasal Polyps and Comorbid Asthma: A 24-Month Study

Tomoko Tajiri et al. J Clin Med. .

Abstract

Background: When considering the effects of dupilumab on severe chronic rhinosinusitis with nasal polyps (CRSwNPs), dupilumab is expected to achieve CRSwNPs remission. The aim of this study was to assess the rate of remission of CRSwNPs with comorbid asthma and its predictors on a 24-month course of dupilumab. Methods: Adult patients with severe CRSwNPs and comorbid asthma who had completed a 24-month course of dupilumab were included in this post hoc analysis. The primary outcome was the rate of CRSwNPs remission at 12 and 24 months of dupilumab. The secondary outcome was to identify factors associated with CRSwNPs remission at 12 and 24 months. Based on the European criteria and a previous definition, remission was defined as the absence of symptoms, improved quality of life, no need for surgery, no exacerbations, recovery of olfactory function, and inactive disease by nasal endoscopy for ≥12 months. A rigorous six-component remission, including olfactory testing, was initially used. Results: Of 16 patients, 4 (25%) and 5 (31%) achieved six-component remission of CRSwNPs at 12 and 24 months, respectively. Patients with shorter disease duration and better olfactory function at baseline achieved six-component remission of CRSwNPs more frequently than those without at 24 months (both p < 0.05). Conclusions: Remission of severe CRSwNPs with comorbid asthma is attainable with a 24-month course of dupilumab.

Keywords: asthma; chronic rhinosinusitis with nasal polyps; dupilumab; nasal endoscopy; olfactory function; remission.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Remission rates of chronic rhinosinusitis with nasal polyps (CRSwNPs) and comorbid asthma at 12 and 24 months. Remission of CRSwNPs included the following criteria: (1) absence of nasal symptoms; (2) no impact of symptoms on quality of life; (3) no need for surgery; (4) no chronic or rescue medications; (5) recovery of smell function; and (6) absence of active disease evaluated by nasal endoscopy for ≥12 months.
Figure 2
Figure 2
Number or rates of patients achieving each individual component of CRSwNPs remission at 12 months (A,C) and 24 months (B,D). Each circle represents a component of remission. The number indicates how many patients fulfilled each component. Abbreviation: QOL, quality of life.
Figure 3
Figure 3
Serial changes in the proportion of patients whose nasal symptoms were present (A), the 22-item of Sinonasal Outcome Test sore (B), the proportion of OCS-dependent patients (C), and recognition threshold of T&T olfactometer (D). * p value by repeated-measures analysis of variance. † p < 0.025 compared with baseline using paired t-test with Bonferroni correction. Abbreviations: M, month; OCS, oral corticosteroid; SNOT-22, the 22-item Sinonasal Outcome Test.
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