Real-world Outcomes After Dupilumab Initiation for Pediatric Crswnp

Sunday, October 18, 2026

4:30 PM - 4:36 PM PT

Location: 409AB

Presenting Author(s)

MH

Maaz S. Haji, BS

Medical Student
Chicago Medical School - Rosalind Franklin University
Decatur, Illinois, United States

Co-Author(s)

AK

Abraham A. Kassem, BS

Research Associate
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Department of Otolaryngology, Head and Neck Surgery, United States
Alexa F. Ibrahim, BA

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Oyster Bay, NY, United States
PG

Paula Valeria Guerra-Navarro, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States
DA

Deepthi Akella, DO

Resident Physician
University of Missouri School of Medicine, United States

Senior Author(s)

MC

Michele M. Carr, DDS MD MEd PhD

Professor
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Dept of Otolaryngology
Buffalo, New York, United States

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is rare but severe in children, with recurrent flares requiring systemic corticosteroids. Dupilumab is increasingly used in difficult-to-treat disease. We evaluated whether dupilumab reduced short-term flare burden and healthcare utilization in children with CRSwNP.

Methods: We conducted a retrospective cohort study using the TriNetX US Collaborative Network of patients aged < 18 years with CRSwNP between 1/1/2015 and 12/31/2024. Mean age was 15.2 years in the dupilumab-treated (DT) cohort and 15.4 years in the non-dupilumab (ND) cohort. DT patients were indexed at treatment initiation and propensity score-matched 1:1 to ND controls indexed at a systemic corticosteroid burst based on asthma, atopic dermatitis, allergic rhinitis, and prior endoscopic sinus surgery. Outcomes within 12 months were compared using risk ratios.

Results: In 442 matched patients (221 per cohort), DT patients had lower rates of acute sinusitis (12/221 [5.4%] vs 31/221 [14.0%]; risk ratio [RR] 0.39; 95%CI:0.20–0.73; p = 0.002), systemic corticosteroid bursts (80/221 [36.2%] vs 101/221 [45.7%]; RR 0.79; 95%CI:0.63–0.99; p = 0.042), and functional endoscopic sinus surgery (19/221 [8.6%] vs 38/221 [17.2%]; RR 0.50; 95% CI:0.30–0.84; p = 0.007). Nasal polyp diagnoses were more frequently documented in the DT cohort (148/221 [67.0%] vs 95/221 [43.0%]; p < 0.0001), while emergency department visits (16/221 [7.2%] vs 27/221 [12.2%]; p = 0.078) and inpatient admissions (12/221 [5.4%] vs 16/221 [7.2%]; p = 0.435) were similar between cohorts.

Conclusions: These real-world findings highlight dupilumab’s clinical utility as a steroid-sparing therapy option for children with CRSwNP, representing a viable therapy for difficult-to-treat patients.