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Dupilumab reduces nasal polyp scores in patients with chronic sinusitis

Patients who received subcutaneous dupilumab in addition to mometasone furoate nasal spray to treat symptomatic chronic sinusitis and nasal polyposis refractory to intranasal corticosteroids achieved a reduced bilateral endoscopic nasal polyp score, according to recent research.

“Among adults with symptomatic chronic sinusitis and nasal polyposis refractory to intranasal corticosteroids, the addition of subcutaneous dupilumab to mometasone furoate nasal spray compared with mometasone alone reduced endoscopic nasal polyp burden after 16 weeks,” Claus Bachert, MD, PhD, of the Upper Airway Research Laboratory and department of otorhinolaryngology at Ghent University Hospital, Ghent, Belgium, and colleagues wrote. “Further studies are needed to assess longer treatment duration, larger samples and direct comparison with other medications.”

Bachert and colleagues evaluated 51 patients (mean age, 48.4 years; 56.7% men) with chronic sinusitis and nasal polyposis refractory to intranasal corticosteroids who received a 600 mg subcutaneous loading dose of dupilumab followed by 300 mg weekly loading doses in addition to mometasone furoate nasal spray, according to the abstract. Additionally, 35 patients had comorbid asthma. Researchers compared these patients with a matched control group that received mometasone furoate nasal spray alone. The researchers monitored change at 16 weeks.

Bachert and colleagues observed a least squares mean change of −1.9 (95% CI, −2.5 to −1.2) in the dupilumab group vs. a mean change of −0.3 (95% CI, −1.0 to 0.4) in the placebo group, for a total mean difference of −1.6 (95% CI, −2.4 to −0.7), according to the abstract. Further, the Lund-Mackay CT total score least squares mean difference was −8.8 (95% CI, −11.1 to −6.6) between the dupilumab and control groups. Researchers found significant improvements in the dupilumab group in the SinoNasal Outcome test (least squares mean difference between both groups, −18.1; 95% CI, −25.6 to −10.6), as well as the University of Pennsylvania Smell Identification Test (least squares mean difference, 14.8; 95% CI, 10.9-18.7).

Bachert and colleagues noted nasopharyngitis occurred in 47% of patients in the dupilumab group vs. 33% in the placebo group, headaches occurred in 20% of the dupilumab group vs. 17% in the placebo group and injection site reactions occurred in 40% of the dupilumab group vs. 7% in the placebo group, according to the abstract. – by Jeff Craven

Disclosure: Bachert reports an advisory board role for Novartis and Sanofi. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.