Dupixent's efficacy in cystic fibrosis related chronic rhinosinusitis with nasal polyposis: a pilot study

Introduction: Cystic fibrosis (CF) patients often contend with chronic rhinosinusitis with nasal polyposis (CRSwNP), with higher relapse rates after surgery compared to non-CF individuals. CRSwNP has a significant impact on their quality of life and increases pulmonary infections risk. Traditional medical and surgical interventions are frequently inadequate. Dupixent is endorsed for persistent CRSwNP following conventional treatment in non-CF subjects; its effectiveness in CF patients remains unexplored considering that those patients are frequently affected by mixed endotypes of CRS with some type-2 features. This study delves into the assessment of Dupixent in CF-related CRSwNP and compares it with a matched control group. Methods: This is a non-randomised single-centre trial enrolling CF patients and non-CF controls. SNOT-22 and NPS scores before, 1 and 6 months after therapy were documented. Results: Dupixent exhibited a significant reduction in SNOT-22 scores after 6 months in both CF and control groups (V = 21, p value = 0.031, both). While NPS scores showed non-significant improvement in CF, the control group experienced a notable reduction after 6 months (V = 10, both; p value = 0.10; p value = 0.034, respectively). No statistical differences were observed between CF and control groups in SNOT-22 and NPS scores after 6 months. Conclusions: This pilot study observed Dupixent's potential in managing CRSwNP in CF patients since SNOT-22 improvement was statistically significant and comparable to the non-CF patients. Although NPS scores improved without statistical significance, no differences emerged between CF and control groups. Therefore, Dupixent achieved comparable results between CF and non-CF patients suffering from CRSwNP.