Dupilumab Improves Symptoms in Patients With Severe CRSwNP and Comorbid Asthma

Dupilumab on a background of mometasone furoate nasal spray improved upper and lower airway outcome measures and health-related quality of life in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma, according to a study published in the Annals of Allergy, Asthma & Immunology.

“In the difficult-to-treat population of patients with CRSwNP with comorbid asthma, the results presented here illustrate that dupilumab as an add-on to the standard-of-care mometasone furoate nasal spray improved symptoms, airway function, and disease control of both the upper (CRSwNP) and lower (asthma) airways concurrently,” wrote lead author Tanya M. Laidlaw, MD, of Harvard Medical School, and coauthors.

The study pooled patients from the phase 3 SINUS-24 and SINUS-52 studies, double-blind trials in which a total 724 patients were randomized to either subcutaneous dupilumab 300 mg or placebo every 2 weeks in addition to standard-of-care mometasone furoate nasal spray. The study focused on outcomes of the 428 participants with CRSwNP and comorbid asthma.

At week 24, patients treated with dupilumab compared with placebo showed improved nasal polyp score (−2.04), patient-reported nasal congestion score (−1.04), Lund-Mackay computed tomography scan score (−6.43), peak nasal inspiratory flow (46.15 L/min), and 22-item sinonasal outcome test score (−21.42), according to the study.

In addition, forced expiratory volume in 1 second (FEV₁) and 6-item asthma control questionnaire scores improved notably with dupilumab compared with placebo.

“In contrast, there was little or no improvement in either CRSwNP or asthma outcome measures in placebo-treated patients who were receiving background intranasal corticosteroids throughout the studies,” researchers wrote. “Dupilumab treatment was generally well tolerated in patients with CRSwNP with comorbid asthma.”

Reference:
Laidlaw TM, Bachert C, Amin N, et al. Dupilumab improves upper and lower airway disease control in chronic rhinosinusitis with nasal polyps and asthma. Ann Allergy Asthma Immunol. 2021;126(5):584-592.e1. doi:10.1016/j.anai.2021.01.012