{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:39:03Z","timestamp":1792031943874,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"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":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory condition that significantly reduces the quality of life due to nasal obstruction, loss of smell and rhinorrhea. Although endoscopic sinus surgery offers relief of symptoms and improvement of quality of life, recurrences are common and multiple surgeries are often required. The aim of this post hoc analysis is to verify the hypothesis that previous multiple surgeries may be associated with poor outcomes with dupilumab in a real\u2010life setting in terms of quality of life, reduction in nasal polyps and improvement of olfaction.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This is a post hoc analysis of the Phase IV real\u2010life multicentre DUPIREAL study in patients with severe uncontrolled CRSwNP treated with dupilumab 300\u2009mg every 2\u2009weeks for 12\u2009months. Inclusion criteria included adherence to treatment and olfactory evaluation measured by Sniffin' Sticks Identification Test 16 (SSIT\u201016). Statistical analyses included multivariate regression, evaluating correlations between baseline factors and poor outcomes in terms of NPS\u2009\u2265\u20094, SNOT\u201022\u2009\u2265\u200930 and SSIT\u201016\u2009\u2264\u200912.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Higher NPS at baseline was associated with an increased risk of NPS >\u20094 at 12\u2009months, whereas a higher number of previous surgeries is associated with a higher probability of lower NPS. Notably, a greater number of previous surgeries was independently associated with incomplete recovery of smell, and surgery\u2010na\u00efve patients had a higher likelihood of achieving complete olfactory recovery. Dupilumab treatment led to a remarkable improvement in olfactory function, with anosmia rates decreasing from 60.2% to 3.3% after 1 year, although in our series, nearly half of the patients still exhibited residual olfactory impairment.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This post hoc analysis highlights the efficacy of dupilumab for the treatment of CRSwNP in real life. Multivariate analysis revealed that multiple prior surgeries negatively impact outcomes with dupilumab during the first year of treatment, especially in terms of olfactory recovery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/coa.70060","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T04:16:03Z","timestamp":1763612163000},"page":"285-295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Influence of Multiple Prior Endoscopic Sinus Surgeries on Dupilumab Efficacy Including Smell Function in the\n DUPIREAL<\/scp>\n Population"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-7018","authenticated-orcid":false,"given":"Eugenio","family":"De Corso","sequence":"first","affiliation":[{"name":"Otorhinolaryngology Unit A. Gemelli University Hospital Foundation IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-0314","authenticated-orcid":false,"given":"Claudio","family":"Montuori","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit A. Gemelli University Hospital Foundation IRCCS Rome Italy"},{"name":"Department of Head, Neck and Sensory Organs Catholic University of the Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7389-2033","authenticated-orcid":false,"given":"Elena","family":"Cantone","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive and Odontostomatological Sciences\u2010ENT Section University of Naples Federico II Naples Italy"},{"name":"Head and Neck Department\u2010ENT Section AOU Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6628-2117","authenticated-orcid":false,"given":"Giorgia Carlotta","family":"Pipolo","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit ASST Santi Paolo e Carlo Hospital Milan Italy"},{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Lucidi","sequence":"additional","affiliation":[{"name":"UOC Otorinolaringoiatria, Dipartimento DIMEC Universit\u00e0 degli Studi di Bologna Ausl Romagna \u2013 Sede di Ravenna Ravenna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8480-0387","authenticated-orcid":false,"given":"Ernesto","family":"Pasquini","sequence":"additional","affiliation":[{"name":"Ospedale Bellaria Dip Chirurgie Specialistiche AUSL BO Otorhinolaryngology Unit Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7155-273X","authenticated-orcid":false,"given":"Ignazio","family":"La Mantia","sequence":"additional","affiliation":[{"name":"Department of Medical \u2013 Surgical Sciences and Advanced Technologies, \u201cG.F. Ingrassia\u201d Director of E.N.T. Unit P.O \u201cG. Rodolico\u201d University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo Francesco","family":"Mastrapasqua","sequence":"additional","affiliation":[{"name":"ENT Department Rivoli Hospital, ASL TO3 Rivoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"De Maio","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit A. Gemelli University Hospital Foundation IRCCS Rome Italy"},{"name":"Department of Head, Neck and Sensory Organs Catholic University of the Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8111-7291","authenticated-orcid":false,"given":"Gian Luca","family":"Fadda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology San Luigi Gonzaga Hospital, University of Turin Orbassano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2433-4761","authenticated-orcid":false,"given":"Giancarlo","family":"Ottaviano","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Otolaryngology Section University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2187-0799","authenticated-orcid":false,"given":"Cecilia","family":"Rosso","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit ASST Santi Paolo e Carlo Hospital Milan Italy"},{"name":"Department of Health Sciences Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Alicandri\u2010Ciufelli","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University Hospital of Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-8034","authenticated-orcid":false,"given":"Veronica","family":"Seccia","sequence":"additional","affiliation":[{"name":"Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4117-1901","authenticated-orcid":false,"given":"Angelo","family":"Ghidini","sequence":"additional","affiliation":[{"name":"Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russo","family":"Paolo","sequence":"additional","affiliation":[{"name":"ENT Department Azienda USL Reggio Emilia, IRCCS Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Dan\u00e9","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Head and Neck Department IRCCS San Raffaele Scientific Institute, Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-373X","authenticated-orcid":false,"given":"Fabio","family":"Pagella","sequence":"additional","affiliation":[{"name":"Department of Clinical, Surgical, Diagnostic and Pediatric Sciences University of Pavia Pavia Italy"},{"name":"IRCCS Policlinico San Matteo Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Sovardi","sequence":"additional","affiliation":[{"name":"Department of Clinical, Surgical, Diagnostic and Pediatric Sciences University of Pavia Pavia Italy"},{"name":"IRCCS Policlinico San Matteo Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Corbo","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit A. 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