Dupilumab’s Impact on Blood Parameters in Nasal Polyposis: 18-Month Follow-Up in Real Life

Abstract

Background. Dupilumab represents the first approved biological for severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP). Objective. Aim of this paper is to provide a multicentric real-life study about treatment with dupilumab for CRSwNP with a special focus on blood parameters and IgE, IgG, and IgA. Method. A retrospective data collection was jointly conducted at the Otolaryngology departments of San Camillo Forlanini Hospital and University of Rome “La Sapienza” from December 2020 to January 2023. Results. A total of 130 patients were included in the study. Monitoring our patients for 18 months, we observed a reduction in nasal polyposis and an improvement in symptoms and their impact on quality of life. Regarding blood tests, a transient increase in blood eosinophils was found in most cases. Total IgE showed a gradual decrease in values. IgG and IgA also showed a slight reduction of values, while remaining within normal ranges. Conclusion. To the best of our knowledge, this is the first study to evaluate the impact of dupilumab on several blood parameters in patients receiving treatment for CRswNP. Further studies are needed to confirm our results and to understand the underlying immunological mechanisms.

Long-Term Perspectives on Chronic Rhinosinusitis with Nasal Polyps: Evaluating Recurrence Rates after Functional Endoscopic Sinus Surgery in the Biologics Era—A 5-Year Follow-Up Study

“…Our study has some limitations, linked primarily to its retrospective nature and the impossibility of investigating parameters, such as IL-5, total IgE, and IL-4/IL-13, which are targets of the current therapy with Mabs [ 51 , 52 , 53 , 54 ].…”

The Impact of Antibiotics and Steroids on the Nasal Microbiome in Patients with Chronic Rhinosinusitis: A Systematic Review According to PICO Criteria

“…The type 2 immune pathway is defined by an overproduction of cytokines interleukin (IL)-13, IL-4, and IL-5; increased IgE; and eosinophils. Clinically, type 2 endotype is the most common in CRSwNP and is typically related to comorbid asthma, loss of smell, and reduced response to standard treatments, with a higher risk of recurrence compared to non-type 2 endotypes [64].…”

Real-Life Evidence of Mepolizumab Treatment in Chronic Rhinosinusitis with Nasal Polyps: A Multicentric Study

“…The SNOT-22 questionnaire consists of 22 personalized questions concerning healthrelated QoL and symptom severity in patients with inflammatory diseases of the nose and paranasal sinuses. The outcomes assessed are classified into two groups: physical symptoms (items 1-12), which include symptoms related to the nasal district (items 1-8), ear symptoms (items 9-11), and facial symptoms (item 12); and QoL and psychological state (items [13][14][15][16][17][18][19][20][21][22] which specifically assess patients' sleep (items [13][14][15][16]) and mental sensations (items [17][18][19][20][21][22]. The total result score can vary from 0 to 110 [21].…”

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