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Late-Breaking Scientific Oral Presentations

Rhinology/Allergy

Session: Late Breaking Scientific Orals 3

Surgery versus dupilumab for chronic rhinosinusitis with nasal polyps: analysis of the Reg-ent data registry

Monday, October 13, 2025
4:54 PM - 5:00 PM EDT
Location: 233-234
Introduction: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) who fail medical management are often offered endoscopic sinus surgery (ESS). Dupilumab (DUP) is used as an adjunct in patients with inadequately-controlled CRSwNP and has been shown to significantly improve outcomes. This study uses a national registry to examine the efficacy of DUP in comparison with ESS for patients with CRSwNP.

Methods: This is a retrospective cohort study using the AAO-HNS Reg-ent data registry. Patients with CRSwNP who underwent ESS or received DUP from 2019 to 2024 were included. Patients who received both were excluded. The primary outcome was Kaplan-Meier estimate of antibiotic/steroid free-probability post-intervention. Secondary outcomes include time to polyp regrowth (beyond 30 days post-intervention), use of CT/MRI, endoscopy and repeat surgery. Outcomes were adjusted for age, sex, ethnicity, history of asthma, allergic rhinitis and dermatitis.

Results: 19,892 patients with CRSwNP received either ESS or DUP. Kaplan-Meier analysis of antibiotic/corticosteroid free-probability over time (from the earliest date of DUP or ESS) demonstrated higher risk among ESS patients compared to DUP patients. The hazard ratio for the DUP group relative to the ESS group was statistically significant in both unadjusted (HR = 0.71) and adjusted (HR = 0.63) Cox models, indicating a 29-37% reduction in the hazard of antibiotic/corticosteroid use among DUP-treated patients compared to ESS patients (p < 0.00001). Kaplan-Meier trends in adjusted secondary outcomes revealed increased risk of nasal polyps in the DUP group beyond 30 days (HR = 1.5, p < 0.00001). There was a similar likelihood of repeat imaging (HR = 1.1, p = 0.44) between both groups. DUP treated patients had decreased risk of endoscopy and surgery (HR = 0.68 and HR = 0.56 respectively, p < 0.00001 for both).

Conclusions: Our analysis found that patients with CRSwNP who received DUP were less likely to need antibiotics or steroids post-intervention than patients who underwent ESS. Patients who received dupilumab also had decreased risk of nasal endoscopy and surgery.

    Presenting Author(s)

  • Christina H. Fang, MD

    Attending Physician, Assistant Professor
    Montefiore Medical Center, Department of Otorhinolaryngology- Head and Neck Surgery
    Bronx, New York, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • DF

    Denisa Ferastraoaru, MD

    Montefiore Medical Center/Albert Einstein College of Medicine, United States

    Disclosure information not submitted.

  • RS

    Richard V. Smith, MD

    Professor and Chair
    Montefiore Medical Center, Department of Otorhinolaryngology- Head and Neck Surgery
    Bronx, New York, United States

    Disclosure information not submitted.

  • PC

    Patrick M. Colley, MD

    Associate Professor of Otolaryngology and Neurosurgery
    Albert Einstein College of Medicine - Montefiore Medical Center
    Bronx, NY, United States

    Disclosure information not submitted.

  • NA

    Nadeem A. Akbar, MD

    Associate Professor
    Montefiore
    Bronx, New York, United States

    Disclosure information not submitted.

  • EB

    Elizabeth Boroweic, MD

    Montefiore Medical Center/Albert Einstein College of Medicine, United States

    Disclosure information not submitted.