Dupilumab improves upper- and lower-airway disease control in chronic rhinosinusitis with nasal polyps and asthma.

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) and type 2 asthma share the same inflammatory pathophysiology and are frequent comorbidities. Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers of type 2 inflammation. Objective: We report the effect of dupilumab vs placebo on outcome measures of the upper and lower airways and health-related quality of life (HRQoL) in the pooled population of patients with CRSwNP and comorbid asthma from the phase III SINUS-24 (NCT02912468) and SINUS-52 (NCT02898454) studies. Methods In these randomized, double-blind, placebo-controlled trials, patients received subcutaneous dupilumab 300 mg (n = 438) or placebo (n = 286) every 2 weeks on a background of mometasone furoate nasal spray. Changes from baseline at week 24 in upper- and lower-airway outcome measures are reported. Results Of 724 patients randomized, 428 (59.1%) had comorbid asthma. In patients with asthma at week 24, dupilumab vs placebo improved nasal polyp score (−2.04), patient-reported nasal congestion score (−1.04), Lund-Mackay CT scan score (−6.43), peak nasal inspiratory flow (46.15 L/minute), and 22-item Sino-Nasal Outcome Test score (−21.42; all P Conclusion Dupilumab improved upper- and lower-airway outcome measures and HRQoL in patients with severe CRSwNP and comorbid asthma, and was well tolerated.