Dupilumab Shows Durable Efficacy in Subgroups of CRSwNP in Real World Data

Anju Peters, MD

Credit: Northwestern University

Dupilumab has continued to demonstrate durability of efficacy in real-world data from patients with chronic rhinosinusitis with nasal polyps (CRSwNP), CRSwNP with coexisting asthma, and CRSwNP with aspirin-exacerbated respiratory disease (AERD).^1,2,3

These findings, from the global, phase 4 registry AROMA study (NCT04959448), were presented in 3 abstracts at the 2025 American Academy of Allergy, Asthma, and Immunology/World Allergy Organization Joint Congress, February 28-March 3, in San Diego, California.

“CRSwNP has a high symptom burden and severely impacts health-related quality of life. Dupilumab significantly reduced symptoms in clinical trials, but evidence in real-world practice is limited,” lead investigator Anju Peters, MD, Professor, Medicine (Allergy and Immunology), Otolaryngology - Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, and colleagues wrote in 1 abstract.¹

AROMA is following 691 patients with CRSwNP being treated with dupilumab in real-world practice in the USA, Canada, Germany, Italy, Japan, and the Netherlands. Of these participants, 478 (69.2%) had coexisting asthma, 160 (23.2%) had AERD, and 74.1% had prior sinonasal surgery. Participants had a median age of 53 years (IQR, 42−61), 55.7% were male, and 69.5% were White.^1,2,3

Investigators found that in patients with CRSwNP, nasal congestion score decreased from a mean of 1.8 (standard deviation [SD], 0.86) at baseline to 0.9 (SD, 0.75) at Month 3 (M3), 0.7 (SD, 0.74) at M12, and 0.5 (SD, 0.66) at M24. Similar improvements were seen with loss of smell score, with a mean score of 2.2 (SD, 1.06) at baseline, 1.2 (SD, 1.04) at M3, 1.0 (SD, 1.02) at M12, and 0.9 (0.96) at M24. SNOT-22 scores (range 0−110) decreased from a mean of 45.9 (standard deviation [SD], 21.37) at baseline to 21.3 (SD, 15.67) at Month 12 (M12), 17.0 (SD, 14.31) at M24, and 18.4 (SD, 14.55) thereafter. The proportions of patients reporting “no symptoms” (based on patient global assessment of symptom severity) increased from 3.3% at baseline to 32.6% at M12 and 42.9% at M24.¹

In patients with CRSwNP and asthma, mean ACQ-6 scores were 1.4 (SD, 1.20) at baseline, 0.5 (SD, 0.65) at M6, 0.4 (SD, 0.62) at M12, and 0.3 (SD, 0.46) at M18. Mini-AQLQ scores (scale 1−7) were 5.1 (SD, 1.29) at baseline, 6.2 (SD, 0.82) at M6, 6.3 (SD, 0.84) at M12, and 6.5 (SD, 0.70) at M18. FeNO levels (ppb) were 62.2 (SD, 66.88) at baseline, 23.5 (SD, 14.58) at M6, 23.0 (SD, 14.95) at M12, and 25.1 (SD, 8.26) at M18. CRSwNP outcomes also showed progressive improvement: nasal congestion scores (range 0−3) were 1.8 (SD, 0.85) at baseline, 0.9 (SD, 0.74) at M3, 0.7 (SD, 0.74) at M12, and 0.6 (SD, 0.65) at M18. Loss of smell scores (range 0−3) were 2.3 (SD, 1.01) at baseline, 1.2 (SD, 1.04) at M3, 1.0 (SD, 1.03) at M12, and 0.9 (SD, 1.01) at M18. SNOT-22 scores (range 0−110) were 46.4 (SD, 20.67) at baseline, 21.1 (SD, 15.60) at M3, 16.0 (SD, 12.98) at M12, and 15.5 (SD, 13.63) at M18.²

In patients with CRSwNP and AERD, mean ACQ-6 scores were 1.3 (SD, 1.07) at baseline, 0.4 (SD, 0.56) at M6, 0.5 (SD, 0.75) at M12, and 0.4 (SD, 0.60) at M18. Mini-AQLQ scores (scale 1−7) were 5.3 (SD, 1.19) at baseline, 6.3 (SD, 0.70) at M6, 6.2 (SD, 0.99) at M12, and 6.3 (SD, 0.79) at M18. FeNO levels (ppb) were 35.5 (SD, 22.68) at baseline, 15.8 (SD, 5.85) at M6, and 15.3 (SD, 6.13) at M12. CRSwNP outcomes also showed progressive improvement: nasal congestion scores (range 0−3) were 1.9 (SD, 0.85) at baseline, 0.8 (SD, 0.74) at M3, 0.7 (SD, 0.77) at M12, and 0.6 (SD, 0.66) at M18. Loss of smell scores (range 0−3) were 2.5 (SD, 0.83) at baseline, 1.3 (SD, 1.02) at M3, 1.0 (SD, 1.02) at M12, and 1.0 (SD, 1.06) at M18. SNOT-22 scores (range 0−110) were 47.6 (SD, 19.53) at baseline, 20.7 (SD, 15.26) at M3, 17.7 (SD, 12.63) at M12, and 15.7 (SD, 13.68) at M18.³

REFERENCES

1. Peters A, Pinto J, De Corso E, et al. Dupilumab Effectiveness Through Two Years in Patients with CRSwNP Treated in Real-World Practice: Results from the Global AROMA Registry. Presented at: 2025 AAAAI/WAO Joint Congress, February 28-March 3. Abstract 579.
2. Buchheit K, Heffler E, Fujieda S, et al. Real-World Dupilumab Effectiveness Through 18 Months in Patients with CRSwNP and Coexisting Asthma: Results from the Global AROMA Registry. Presented at: 2025 AAAAI/WAO Joint Congress, February 28-March 3. Abstract 232
3. White A, Buchheit K, Laidlaw T, et al. Real-World Effectiveness of Dupilumab Through 18 Months in Patients with CRSwNP and AERD: Results from the Global AROMA Registry. Presented at: 2025 AAAAI/WAO Joint Congress, February 28-March 3. Abstract 924.