The Efficacy of Dupilumab as an Adjuvant Treatment After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps: A Retrospective Cohort Analysis

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OBJECTIVES: Chronic rhinosinusitis with nasal polyps (CRSwNP) demonstrates a high recurrence rate following endoscopic sinus surgery (ESS). The role of adjunctive biologic therapy remains incompletely understood. This study aims to assess the efficacy of dupilumab when used in conjunction with ESS for patients with CRSwNP. METHODS: We conducted a retrospective cohort study of type 2 CRSwNP patients who underwent ESS. The study compared patients receiving postoperative dupilumab with those receiving standard care. Changes in the Lund-Kennedy endoscopic score (LKES) and nasal polyp score (NPS) were recorded, and linear mixed models (LMMs) were employed for the primary outcome analysis. RESULTS: The study enrolled 49 CRSwNP patients, with 22 patients in the dupilumab group. Postoperative LKES and NPS decreased in both groups. LMM analysis revealed a significant improvement in LKES (B=-0.61; 95% CI, -0.90 to -0.31; P<0.001) and a more pronounced improvement in NPS (B=-0.14; 95% CI, -0.25 to -0.02; P=0.025) in the dupilumab group compared to controls from preoperative to postoperative measurements. CONCLUSION: Compared to ESS alone, the adjunctive use of dupilumab in the postoperative period was associated with greater reductions in both NPS and endoscopic scores.

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