TOPLINE

Among adults with severe chronic rhinosinusitis with nasal polyps (CRSwNP) and concomitant eosinophilic otitis media (EOM), dupilumab treatment was associated with progressive improvement in otitis-related quality of life and middle-ear function over 12 months.

METHODOLOGY

• Researchers conducted a multicenter retrospective cohort study to evaluate the 12-month effectiveness of dupilumab on otologic outcomes in 48 patients (mean age, 58.1 years; 50.0% women) with severe CRSwNP and concomitant EOM.
• All patients received 300 mg dupilumab every 2 weeks according to the approved indication for severe CRSwNP, with outcomes assessed at baseline, 6 months, and 12 months.
• The primary otologic outcomes were tympanometry findings and scores on the Chronic Otitis Media Outcome Test 15 (COMOT-15), a disease-specific quality-of-life instrument, with higher scores indicating greater disease burden.
• Tympanometry findings were grouped into three patterns: type A, indicating healthy middle-ear pressure and normal mobility; type B, a flat curve pointing to middle-ear effusion; and type C, a curve shifted toward negative middle-ear pressure, pointing to a problem with Eustachian tube function.
• Secondary sinonasal outcomes included the Nasal Polyp Score, scores on the Sinonasal Outcome Test 22 (SNOT-22), and scores on the visual analog scale (VAS) for nasal congestion.

TAKEAWAY

• A significant association was observed between dupilumab treatment and improvement in EOM-related quality of life, with the median COMOT-15 score dropping from 49 at the start of the treatment to 20 after 6 months and further down to 15 at 12 months (P < .0001); the median absolute change from baseline was a decrease of 26.0 points at 6 months and a decrease of 32.5 points at 12 months.
• Tympanometry findings improved progressively: At baseline, 32 patients had type B patterns and 16 had type C patterns; by 12 months, 36 had shifted to type A and 12 remained type C; none of the patients’ tympanometric readings got worse at any point during the study.
• Sinonasal measures improved in parallel, with the median Nasal Polyp Score decreasing from 6 to 2, the SNOT-22 score decreasing from 68 to 22, and the VAS score for nasal congestion decreasing from 8 to 1 by 12 months (P < .0001 for all).

IN PRACTICE

"These findings support the concept that EOM and CRSwNP may represent connected manifestations of a multi-compartment type 2 inflammatory disorder. Dupilumab may therefore have therapeutic relevance for EOM in selected patients with severe CRSwNP," the authors wrote.

SOURCE

Cosimo Galletti, MD, with the University Kore of Enna, Enna, Italy, was the corresponding author of the study, which was published online on September 11 in the American Journal of Rhinology & Allergy.

LIMITATIONS

This was an observational study without a comparison group; therefore, the improvements could not be definitively attributed to dupilumab alone. These findings cannot be generalized to patients with isolated EOM without CRSwNP, since all patients in this study received dupilumab for severe CRSwNP. Moreover, audiometric data were not collected systematically.

DISCLOSURES

The authors received no financial support for the study and declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.