{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T05:43:54Z","timestamp":1792388634811,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Long\u2010term management strategies for severe chronic rhinosinusitis with nasal polyps (CRSwNP) increasingly include biologic therapy targeting Type 2 inflammation. However, data on outcomes after complete discontinuation of dupilumab following sustained disease control are scarce.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this single\u2010center, retrospective real\u2010world study, adult CRSwNP patients who discontinued dupilumab after \u2265 2 years of treatment and sustained good\u2010to\u2010excellent disease control were included. Disease control at cessation was defined according to EPOS\/EUFOREA\u2010aligned criteria (bilateral nasal polyp score [NPS] \u2264 2; SNOT\u201022 < 20). Patients were followed for up to 12 months. Outcomes included SNOT\u201022, visual analog scale (VAS), NPS, olfactory function (SSIT\u201012), relapse timing, and reinitiation of therapy.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 46 patients were included (median treatment duration 189.7 weeks). At discontinuation, disease control was excellent (mean SNOT\u201022 10.1 \u00b1 6.1; NPS 0.2 \u00b1 0.5). Within 3 months, a marked and statistically significant deterioration occurred across all major outcomes (SNOT\u201022 36.4 \u00b1 20.0; VAS 5.0 \u00b1 2.7; NPS 1.5 \u00b1 1.9; all\n p<\/jats:italic>\n < 0.001). Median time to first symptom worsening was 7.6 weeks. Most The majority of patients (87.0%) reinitiated dupilumab within 12 months, primarily due to nasal symptom recurrence. Retreatment led to rapid and significant clinical improvement. Six patients remained off therapy, but demonstrated progressive objective and\/or subjective worsening over time.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Complete discontinuation of dupilumab after long\u2010term disease control appears feasible in only a minority of patients and is associated with early relapse in most cases. These findings support the concept of dupilumab as a disease\u2010controlling rather than disease\u2010modifying or curative therapy and favor individualized dose tapering over full cessation in severe Type 2\u2013driven CRSwNP.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/alr.70241","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T16:07:06Z","timestamp":1786464426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Longitudinal Evaluation After Regimen Stop (CLEAR) of Dupilumab in Chronic Rhinosinusitis With Nasal Polyps (CRSwNP)"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6962-9999","authenticated-orcid":false,"given":"Patrick","family":"Huber","sequence":"first","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Lasch","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Volgger","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Stihl","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Teupe","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Oettgen","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Gantner","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Gr\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Head and Neck Surgery, Ludwig Maximilian University of Munich Munich Germany"},{"name":"HNO am Maximiliansplatz Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"issue":"29","key":"e_1_2_11_2_1","first-page":"1","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2020","volume":"58","author":"Fokkens W. 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M.","year":"2021","journal-title":"Journal of Allergy and Clinical Immunology"},{"issue":"8","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.3390\/jpm12081251","article-title":"Sinonasal Biomarkers Defining Type 2\u2010High and Type 2\u2010Low Inflammation in Chronic Rhinosinusitis With Nasal Polyps","volume":"12","author":"De Corso E.","year":"2022","journal-title":"Journal of Personalized Medicine"},{"issue":"1","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jaci.2020.11.013","article-title":"EUFOREA Expert Board Meeting on Uncontrolled Severe Chronic Rhinosinusitis With Nasal Polyps (CRSwNP) and Biologics: Definitions and Management","volume":"147","author":"Bachert C.","year":"2021","journal-title":"Journal of Allergy and Clinical Immunology"},{"issue":"1","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/cea.13491","article-title":"Mechanisms of Dupilumab","volume":"50","author":"Harb H.","year":"2020","journal-title":"Clinical & Experimental Allergy"},{"issue":"10209","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1016\/S0140-6736(19)31881-1","article-title":"Efficacy and Safety of Dupilumab in Patients With Severe Chronic Rhinosinusitis With Nasal Polyps (LIBERTY NP SINUS\u201024 and LIBERTY NP SINUS\u201052): Results From Two Multicentre, Randomised, Double\u2010Blind, Placebo\u2010Controlled, Parallel\u2010Group Phase 3 Trials","volume":"394","author":"Bachert C.","year":"2019","journal-title":"Lancet"},{"issue":"11","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"3108","DOI":"10.1111\/all.16263","article-title":"Real\u2010World Data Show Sustained Therapeutic Effects of Dupilumab in Chronic Rhinosinusitis With Nasal Polyps (CRSwNP) Over 3\u2009Years","volume":"79","author":"Huber P.","year":"2024","journal-title":"Allergy"},{"issue":"10","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1111\/all.15772","article-title":"Dupilumab in the Treatment of Severe Uncontrolled Chronic Rhinosinusitis With Nasal Polyps (CRSwNP): A Multicentric Observational Phase IV Real\u2010Life Study (DUPIREAL)","volume":"78","author":"De Corso E.","year":"2023","journal-title":"Allergy"},{"issue":"2","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1111\/all.15134","article-title":"Real\u2010Life Observational Cohort Verifies High Efficacy of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps","volume":"77","author":"Lans R. 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