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European Archives of Oto-Rhino-Laryngology

Open Access 06-05-2024 | Dupilumab | Rhinology

The value of biomarkers in the therapy of CRSwNP with biologicals—a long-term follow-up of dupilumab therapy

Authors: Sven Ole Sarnoch, Amra Pepić, Lisa Schmitz, Benjamin Becker, Christian Betz, Anna-Sophie Hoffmann

Published in: European Archives of Oto-Rhino-Laryngology

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Abstract

Purpose

Since its release, Dupilumab has shown great results in treating severe uncontrolled CRSwNP. However, there is a lack of real-world data beyond 12 months of follow-up, and it is not clear to what extent biomarkers are appropriate for monitoring and predicting the Dupilumab therapy success. Hence, this study aims to analyze biomarkers for monitoring therapy, predicting therapy success and assess the effect of Dupilumab in real-world settings.

Methods

The follow-up was performed with 104 patients retrospectively up to 22 months, assessing SNOT-22, NPS, olfactometry, ACS, FEV-1, and blood biomarkers (total serum IgE, Eosinophils, ECP). Patients were divided into subgroups depending on their pretherapeutic biomarker levels and subsequent development was analyzed.

Results

There was substantially improvement in all clinical parameters up to 1 year and then continuously up to month 22. Patients with initially elevated baseline blood eosinophil counts (> 0.5 billion/L) had a trend of better SNOT-22 development after 1 year (− 12.19 points, p = 0.03). The course of total serum IgE showed moderate correlation with almost all clinical variables obtained. Therapy was well tolerated with only mild and transient adverse events.

Conclusion

Dupilumab has considerably reduced symptoms and disease severity even beyond 1 year of treatment, supporting its role as targeted and effective treatment option for CRSwNP. Our data shows that total serum IgE is a promising biomarker for the monitoring during the treatment with Dupilumab. Elevated pre-therapeutic serum eosinophil counts may be a predictor of good subjective response to therapy. Larger cohorts and a long-term-follow-up over years are needed to further consolidate these findings.
Appendix
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Metadata
Title
The value of biomarkers in the therapy of CRSwNP with biologicals—a long-term follow-up of dupilumab therapy
Authors
Sven Ole Sarnoch
Amra Pepić
Lisa Schmitz
Benjamin Becker
Christian Betz
Anna-Sophie Hoffmann
Publication date
06-05-2024
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-024-08574-4