Effect of dupilumab on otitis media associated with eosinophilic chronic rhinosinusitis

Objective: Eosinophilic Otitis Media (EOM) is an intractable disease caused by type 2 inflammation, such as Eosinophilic Chronic Rhinosinusitis (ECRS) and bronchial asthma. Biologics have recently been used to treat ECRS and bronchial asthma. Biologics are not indicated for EOM; however, because approximately 10% of ECRS cases has concomitant EOM, concomitant EOM improvement has been observed when dupilumab is administered for ECRS. Therefore, we aimed to investigate the current status of EOM treatment and clarify the effect of dupilumab on EOM.

Method: This retrospective study included 25 patients attending our hospital. The disease status of patients with EOM not treated with dupilumab (control) and those treated with dupilumab at the time of evaluation were compared. The EOM disease status was compared using the EOM severity score, temporal bone shadow on Computed Tomography (CT), and standard pure tone audiometry.

Result: Twenty-four of the 25 patients with EOM had concomitant ECRS, and 12 were administered with dupilumab. The severity score of EOM, temporal bone CT score, and air conductance hearing were significantly improved after dupilumab administration in 12 patients with EOM. Comparison of EOM patients without dupilumab (control) and those treated with dupilumab at the time of evaluation revealed that the severity score of EOM, temporal bone CT score, and air conduction hearing were significantly better in patients treated with dupilumab.

Conclusion: Our study demonstrated that dupilumab was administered to approximately half of the patients with EOM, suggesting that the treatment of EOM has undergone significant changes due to dupilumab administered to ECRS. Our study also suggests that dupilumab is highly effective in patients with EOMs.