Liu Chin-Nung, Yeh Te-Huei, Lin Chih-Feng, Lin Yi-Tsen
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Otolaryngology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Clin Exp Otorhinolaryngol. 2025 Aug;18(3):271-279. doi: 10.21053/ceo.2024.00310. Epub 2025 Apr 8.
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.
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.
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.
Compared to ESS alone, the adjunctive use of dupilumab in the postoperative period was associated with greater reductions in both NPS and endoscopic scores.
鼻息肉型慢性鼻-鼻窦炎（CRSwNP）在内镜鼻窦手术（ESS）后复发率较高。辅助生物治疗的作用仍未完全明确。本研究旨在评估度普利尤单抗联合ESS用于CRSwNP患者的疗效。
我们对接受ESS的2型CRSwNP患者进行了一项回顾性队列研究。该研究将术后接受度普利尤单抗治疗的患者与接受标准治疗的患者进行了比较。记录Lund-Kennedy内镜评分（LKES）和鼻息肉评分（NPS）的变化，并采用线性混合模型（LMMs）进行主要结局分析。
该研究纳入了49例CRSwNP患者，度普利尤单抗组有22例患者。两组术后LKES和NPS均下降。LMM分析显示，与对照组相比，度普利尤单抗组从术前到术后测量，LKES有显著改善（B=-0.61；95%CI，-0.90至-0.31；P<0.001），NPS改善更明显（B=-0.14；95%CI，-0.25至-0.02；P=0.025）。
与单纯ESS相比，术后辅助使用度普利尤单抗可使NPS和内镜评分有更大幅度的降低。
