Outcomes of Dupilumab in Surgically Refractory Chronic Rhinosinusitis with Nasal Polyps: A Matched Cohort Study

Tuesday, October 20, 2026

8:06 AM - 8:12 AM PT

Location: Theatre 411

Presenting Author(s)

AS

Alisha Suri, BSc

Medical Student
Alisha Suri
Honolulu, Hawaii, United States

Co-Author(s)

HZ

Henry Zheng, MD

Resident Physician
Kaiser Permanente Oakland, United States
KL

Kathy C. Le, MPH

Data Analyst
Kaiser Permanente Northern California Division of Research
San Jose, CA, United States
JW

Julia C. Wei, MPH

Data Analyst
Kaiser Permanente Northern California Division of Research
Sacramento, CA, United States

Senior Author(s)

JL

Jonathan Liang, MD

Associate Professor
Kaiser Permanente
Oakland, California, United States

Disclosure(s):

Kathy C. Le, MPH:

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

Julia Wei, MPH:

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

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a refractory inflammatory condition associated with substantial morbidity, frequent medical therapy, and repeated surgical intervention. Although dupilumab has demonstrated clinical efficacy in randomized trials, its real-world impact on healthcare utilization remains incompletely defined.

Methods: Adult patients with eosinophilic CRSwNP who underwent endoscopic sinus surgery (ESS) between 2017 and 2023 were identified using ICD-10 and CPT codes. Dupilumab-treated patients with ≥4 months of therapy were matched 1:3 to CRSwNP controls based on age category, asthma comorbidity, and Neighborhood Deprivation Index. Cox proportional hazards was used to assess revision ESS, and multivariable logistic and negative binomial regression were performed to evaluate systemic antibiotic and corticosteroid use.

Results: The cohort included 644 patients (161 dupilumab-treated, 483 controls) with a median follow-up of 36 months. Revision ESS occurred in 25 patients (11.8 vs 16.6 per 1,000 person-years in dupilumab-treated patients and controls, respectively), and dupilumab treatment was associated with a lower hazard of revision surgery (adjusted HR 0.31, 95% CI 0.11-0.71). Adjusted one-year odds ratio (OR) and incidence rate ratio (IRR) for systemic antibiotics were 1.54 (95% CI 0.96-2.47) and 1.14 (95% CI 0.79-1.65), respectively. Adjusted one-year OR and IRR for systemic corticosteroid use were 0.85 (95% CI 0.48-1.48) and 0.70 (95% CI 0.45-1.09), respectively.

Conclusions: Dupilumab was associated with a 69% reduction in revision ESS hazard. Dupilumab was not associated with reductions in antibiotic use, and further exploration is needed to examine its effect on corticosteroid use. These findings support dupilumab’s real-world clinical value and impact on healthcare utilization.