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Objective: This study aimed to evaluate the clinical remission rate and changes in medication use in patients with eosinophilic chronic rhinosinusitis (ECRS) treated with dupilumab for > 2 years. Methods: This retrospective study included 19 patients with ECRS who received dupilumab therapy for > 2 years. The nasal polyp, Lund-Mackay on sinus CT, and SNOT-22 scores were assessed at baseline, 3 months, 1 year, and at the final evaluation. Remission was defined as sustained fulfillment of specific clinical and endoscopic criteria for at least 12 months. The use of concomitant medications was also assessed. Results: Polyp score significantly improved from 6.1 ± 0.6 at baseline to 0.68 ± 1.2 at final evaluation. SNOT-22 scores decreased from 42.8 ± 20.0 to 14.1 ± 10.2. Clinical remission was achieved in 15 patients (79%). The remaining four patients did not meet the remission criteria because of persistent olfactory dysfunction or nasal obstruction. Significant reductions in the use of oral corticosteroids, drop-type intranasal corticosteroids, nasal spray corticosteroids, leukotriene receptor antagonists, and inhaled corticosteroids were also observed. Conclusion: Dupilumab therapy for > 2 years resulted in a high clinical remission rate and reduced the need for concomitant medications in patients with ECRS. Persistent olfactory dysfunction is the main reason for non-remission, indicating the need for further therapeutic strategies in such refractory cases. Level of Evidence: 3.
Kamimura et al. (Tue,) studied this question.