# Clinical effectiveness of dupilumab in CRSwNP: unaffected by baseline nasal polyp size in real-world settings

## TL;DR

Dupilumab treatment for nasal polyps is effective regardless of initial polyp size in real-world clinical settings.

## Contribution

Shows dupilumab's effectiveness is not affected by baseline nasal polyp size in CRSwNP patients.

## Key findings

- Both low- and high-NPS groups showed significant decreases in nasal polyp scores after dupilumab treatment.
- Patients with high baseline NPS had greater improvement in SNOT-22 scores compared to low-NPS patients.
- Proportions of clinically significant improvement were similar between low- and high-NPS groups.

## Abstract

This study aimed to investigate the impact of baseline nasal polyp score (NPS) on the effectiveness of dupilumab treatment in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

In this retrospective observational study, 80 CRSwNP patients treated with dupilumab 300 mg biweekly at a tertiary referral center were stratified according to the baseline NPS into two groups: low-NPS (< 5) and high-NPS (≥ 5). Treatment outcomes were evaluated at the 6-month follow-up visit and compared.

Both groups showed significant clinical improvements. The NPS decreased significantly in both low- and high-NPS groups, from a mean score of 3.2 to 0.8 and from 6.1 to 1.4, respectively (p < 0.001 for both). SNOT-22 scores improved significantly in both groups (p < 0.001 for both), though the reduction was greater in the high-NPS group (35.5 vs. 23.9, p = 0.018). There were no significant differences between low- and high NPS groups in proportions of NPS reduction of ≥ 1 (89% vs. 95%, p = 0.396) and clinically significant SNOT-22 improvement (= reduction > 12 or follow-up SNOT < 40; 80% vs. 86%, p = 0.544).

Our results suggests that dupilumab is effective in CRSwNP treatment, regardless of baseline nasal polyp size. Both small and large polyp groups showed significant improvements in NPS and patient-reported outcome measures. Future, prospective studies are warranted to validate these findings.