{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T16:53:27Z","timestamp":1791132807849,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","award":["LTR DTD 100322"],"award-info":[{"award-number":["LTR DTD 100322"]}],"id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI146131"],"award-info":[{"award-number":["R01AI146131"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease treated with endoscopic sinus surgery (ESS) or targeted biologic therapy such as dupilumab. Prospective real\u2010world data guiding treatment decisions remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center, prospective, real\u2010world observational cohort study of adults with severe CRSwNP treated with ESS or dupilumab following structured shared decision\u2010making. All patients met EPOS diagnostic criteria and were followed for 12\u00a0months. Standardized assessments were performed at baseline and every 3\u00a0months, including disease\u2010specific quality of life (SNOT\u201022), olfaction (UPSIT\u201040), nasal congestion score (NCS), and endoscopic nasal polyp score (NPS). CRS exacerbations were prospectively monitored using biweekly symptom surveys, with endoscopic culture obtained during exacerbations with mucopurulence. Longitudinal outcomes were analyzed using mixed\u2010effects models, and bacterial exacerbation incidence was evaluated using regression and survival analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty adults completed 12\u2010month follow\u2010up (dupilumab,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a020; ESS,\n                      <jats:italic>n\u00a0<\/jats:italic>\n                      =\u00a030). Both treatments resulted in significant improvements across patient\u2010reported and objective outcomes, exceeding minimal clinically important differences. ESS was associated with more rapid early improvement, whereas dupilumab demonstrated more durable improvement in symptoms, olfaction, and nasal congestion. CRS exacerbations and culture\u2010confirmed bacterial infections occurred less frequently in dupilumab\u2010treated patients, with lower cumulative bacterial burden and longer infection\u2010free survival.\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      was the most common pathogen and more frequent among ESS\u2010treated patients. Bacterial infection was associated with persistently higher symptom burden and worse longitudinal outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      ESS and dupilumab both provide meaningful benefit in severe CRSwNP, with distinct temporal response patterns. Reduced exacerbations and bacterial infections\u2014particularly\n                      <jats:italic>S. aureus<\/jats:italic>\n                      \u2014were associated with more favorable disease trajectories, underscoring the importance of infection control in individualized treatment selection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70163","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T11:59:47Z","timestamp":1776427187000},"page":"1084-1093","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Real\u2010World Outcomes of Endoscopic Sinus Surgery and Dupilumab in Severe Chronic Rhinosinusitis With Nasal Polyps"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3376-9591","authenticated-orcid":false,"given":"Nirushan","family":"Narendran","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Arizona  Tucson Arizona USA"},{"name":"Asthma and Airway Disease Research Center University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Irish","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Arizona  Tucson Arizona USA"},{"name":"Asthma and Airway Disease Research Center University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shireen","family":"Samargandy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head &amp; Neck Surgery King Faisal Specialist Hospital &amp; Research Center  Riyadh Saudi Arabia"},{"name":"College of Medicine Al Faisal University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Carr","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Arizona  Tucson Arizona USA"},{"name":"Asthma and Airway Disease Research Center University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher H.","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene H.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Arizona  Tucson Arizona USA"},{"name":"Asthma and Airway Disease Research Center University of Arizona  Tucson Arizona 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