Background: Research on the immune mechanism behind chronic rhinosinusitis (CRS) has
revealed various new endotypes, leading to targeted therapies, especially for severe
uncontrolled CRS. Biologics are novel therapeutic strategies providing targeted treatment
for the difficult-to-treat recalcitrant CRSwNP patients. Dupilumab is a fully human-derived
monoclonal antibody that binds to IL4Rα, inhibiting the signalling of both IL-4 and
IL-13. In Hungary, it is approved for the treatment of uncontrolled CRSwNP according
to criteria based on the EPOS2020 and the Hungarian guidelines. Methodology: This
study aimed to collect and evaluate real-world therapeutic data of CRSwNP patients
treated with dupilumab. One hundred thirty-five patients from eight different referral
centres have been enrolled in this study, who received dupilumab since 2020. All subjects
were adult patients (>18 years) with uncontrolled CRSwNP. Baseline data collection
included demographics, medical history, previous surgeries, related comorbidities,
total endoscopic nasal polyp score (NPS), SNOT22, nasal congestion parameters measured
with visual analogue scale (VAS) and nasal obstruction evaluation scale (NOSE), loss
of smell score (LSS) and eosinophil count. 300 mg dupilumab was administered subcutaneously
every second week. Follow up visits were performed after 6 and 12 months. Results:
After 6 and 12 months of treatment significant improvement was detected in all clinical
parameters. Safety was proved, no severe side effects occurred, and no rescue treatment
was necessary. Conclusions: Our real-life findings show that continuous dupilumab
treatment is effective and safe in daily clinical practice in CRSwNP and other type
2 comorbidities such as bronchial asthma and NERD.
