Therapeutic Effectiveness SNOT 22-based interdose interval adjustment of dupilumab for CRSwNP

Objectives: This study aims to evaluate whether Sino-nasal Outcome Test (SNOT-22)-based interdose interval adjustment of dupilumab demonstrates enduring efficacy and patient satisfaction in chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods: A retrospective analysis was conducted using planned data collection from 44 patients who received dupilumab and had been followed up for more than 6 months, targeting individuals with CRSwNP based on the EPOS 2020 Criteria. Patients were treated with add-on dupilumab by adjusting the interdose interval based on SNOT-22, which was tapered when subjects with >40 SNOT-22 at pretreatment evaluation were controlled at the level of ≤20 SNOT-22; when subjects with ≤40 SNOT-22 at pretreatment evaluation were controlled at the level of ≥50% improvement. SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire modified from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4) were assessed at each visit.

Results: The SNOT-22-based interdose interval adjustment of dupilumab showed sustained improvement in patients' subjective symptoms, satisfaction, and NPS. Mean scores (S.D) of SNOT-22 improved from 46.04 (22.30) to 14.72 (13.66) at 6 months (p=0.000); NPS improved from 3.20 (2.24) to 1.72 (1.46) at 6 months (p=0.000). Satisfaction scores (0-5) were well maintained above 3.5 points for up to 6 months(p=0.166). There was also a significant correlation between the improvement in the nasal symptom domain of SNOT-22 scores and higher satisfaction scores.

Conclusion: Adjusting dupilumab intervals based on SNOT-22 from the start leads to sustained efficacy and patient satisfaction in Korean CRSwNP. This will be of great clinical help in determining the optimal dupilumab interval.