Reduction of Rescue Treatment With Dupilumab for Chronic Rhinosinusitis With Nasal Polyps in Japan.

Abstract

Add-on dupilumab provides significant symptomatic improvement for individuals with chronic rhinosinusitis with nasal polyps (CRSwNP); however, little is known about the impact of dupilumab in reducing rates of rescue treatment for CRSwNP in Japanese real-world practice settings. This observational study examined the impact of add-on dupilumab treatment on disease burden, including the use of rescue therapy, in Japanese individuals with CRSwNP. The study analyzed individual participant data from a Japanese hospital-based administrative claims database between January 1, 2019, and March 31, 2023. Data were collected for each individual from 12 months prior to the index date (the start date of dupilumab administration) to 12 months after the index date (follow-up period). The primary outcome was the change in overall rate of rescue treatment (systemic corticosteroid [SCS] use or endoscopic sinus surgery [ESS]) before and after the initiation of dupilumab. The study included 438 individuals with CRSwNP (mean ± SD age of 53.9 ± 13.4 years; 56.6% male). The overall rate of rescue treatment before and after initiation of dupilumab treatment was 7.89 events per patient-year (PY) and 2.14 events per PY, respectively (p < 0.0001), and there was a 73% reduction in the rate of rescue treatment. Compared with the pre-index period, a lower rate of SCS prescriptions (7.54 vs. 2.05) and ESS procedures (0.35 vs. 0.05) during the follow-up was observed, respectively, and there was a 72% reduction in the rate of SCS prescriptions. The mean ± SD daily SCS dose decreased from 7.1 ± 9.7 mg in the pre-index period to 6.1 ± 7.3 mg during follow-up. In this real-world study, add-on dupilumab treatment significantly reduced the requirement for rescue treatment in Japanese individuals with CRSwNP.