ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025
Early real-life outcomes of dupilumab and mepolizumab in patients with uncontrolled primary diffuse type 2 chronic rhinosinusitis.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Real-world sinonasal outcomes in patients with primary diffuse chronic rhinosinusitis treated with mepolizumab across polyp phenotypes.Frontiers in immunology · 2026Article
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Abstract
purposeChronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease causing significant morbidity. Biologics such as dupilumab (anti-IL-4Ra) and mepolizumab (anti-IL-5) are effective treatments; however, comparative real-world data remain limited. This study evaluates their effectiveness over the first six months in patients with uncontrolled primary diffuse Type 2 chronic rhinosinusitis.
methodsA retrospective analysis was conducted on 85 CRSwNP patients treated at Padova University Hospital (58 dupilumab, 27 mepolizumab). Patient-reported (SNOT-22, VAS scores) and clinician-reported (NPS, SSIT, PNIF) outcomes were assessed at baseline (T0), one month (T1), three months (T3), and six months (T6).
resultsDupilumab showed a rapid and significant improvement in all assessed PROMs and CROMs (p < 0.001), with a marked reduction in nasal polyp size and superior early olfactory recovery. By six months, 17% of dupilumab-treated patients achieved normosmia versus 7% in the mepolizumab group. Mepolizumab improved most outcomes except VAS-smell and significantly reduced blood eosinophil counts (p < 0.001), whereas dupilumab had no significant effect. According to EUFOREA 2023 criteria, 70% of dupilumab-treated patients had a moderate to excellent response versus 37% in the mepolizumab group.
conclusionBoth biologics are effective for CRSwNP, but their efficacy profiles differ. Dupilumab provides faster olfactory and nasal polyp improvements. Personalized biologic selection is essential, and further studies are needed to define long-term outcomes.
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