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Late-Breaking Scientific Oral Presentations

Rhinology/Allergy

Session: Late Breaking Scientific Orals 3

Dupilumab Reduces Bacterial Exacerbations in CRSwNP: A One-Year Prospective Comparison with Endoscopic Sinus Surgery

Monday, October 13, 2025

4:30 PM - 4:36 PM EDT

Location: 233-234

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory condition often requiring long-term management. Dupilumab, a monoclonal antibody targeting the IL-4Rα subunit, has shown promise in reducing inflammation in CRSwNP, but its impact on infection-related exacerbations compared to surgical intervention remains underexplored. Our objective is to prospectively evaluate the incidence of bacterial exacerbations in patients with CRSwNP treated with Dupilumab versus those undergoing endoscopic sinus surgery (ESS) over a 12-month period.

Methods: In this prospective cohort study, 50 patients with CRSwNP were enrolled, with 20 receiving Dupilumab and 30 undergoing ESS. Baseline demographic and clinical characteristics were comparable between groups. The primary outcomes were (1) the proportion of patients experiencing at least one bacterial infection and (2) the total incidence of positive bacterial infections over the study period. Chi-square tests were used to assess statistical significance.

Results: Patients in the Dupilumab group had significantly fewer positive bacterial infections than those in the ESS group (6 vs. 19 patients; p = 0.0421). The total incidence of infections was also lower in the Dupilumab cohort (8 vs. 35 infections; p = 0.0034). A time-based analysis revealed a consistently lower relative risk of sick visits over 12 months in the Dupilumab group. Moreover, S. aureus was disproportionately more prevalent in the ESS group compared to the Dupilumab group (p = 0.027).

Conclusions: Dupilumab therapy significantly reduces both the rate and incidence of bacterial exacerbations in patients with CRSwNP compared to ESS over a one-year period. These findings suggest that Dupilumab may offer protective benefits against bacterial exacerbations in addition to its anti-inflammatory effects.

Presenting Author(s)

NN

Nirushan Narendran, MS

University of Arizona College of Medicine - Tucson, Arizona, United States

Disclosure information not submitted.

Co-Author(s)

JI

Joseph Irish, BS

Univ of Arizona College of Medicine, United States

Disclosure information not submitted.
SS

Shireen Samargandy, MBBS

King Abdulaziz University, Department of Otolaryngology–Head and Neck Surgery, United States

Disclosure information not submitted.
tC

tara Carr, MD

Univ of Arizona College of Medicine, Arizona, United States

Disclosure information not submitted.
Christopher H. Le, MD, FACS

Associate Professor
University of Arizona College of Medicine - Tucson
Tucson, Arizona, United States

Disclosure information not submitted.

Senior Author(s)

EC

Eugene H. Chang, MD

Vice Chair
Univ of Arizona College of Medicine
Tucson, AZ, United States

Disclosure information not submitted.