ROLE OF BODY MASS INDEX AS A PREDICTOR OF DUPILUMAB EFFICACY IN PATIENTS WITH SEVERE CRSwNP. | ACTA Otorhinolaryngologica Italica

Abstract

Objective: Response to Dupilumab for CRSwNP, albeit almost always excellent, is still not predictable. Our study focuses on the role of BMI on Dupilumab efficacy.
Methods: We present a retrospective multicenter study of 106 Dupilumab patients, stratified in 3 BMI subgroups. The main investigated therapeutic outcomes include Nasal Polyp Score, Sino-Nasal-Outcome Test – 22, Sniffin’ Sticks Identification test and VAS, and the different timing of response, according to De Corso et al criteria.
Results: Dupilumab treatment determined a progressive improvement for all the outcomes at all the endpoints. Comparing the different metabolic subgroups, a late response in terms of NPS decrease was observed only in three obese patients. A statistically significant difference was also found in SNOT-22 score decrease at 6 and 12 months, less marked in overweight/obese patients.
Conclusion: Our study confirmed the efficacy of dupilumab in every metabolic subgroup. However, such efficacy seems to follow different timing relative with respect to patients’ metabolic state. Our data suggest that patients with a compromised metabolic state present a more severe baseline disease and a possibly delayed response to dupilumab.