{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:24:14Z","timestamp":1792797854360,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease that significantly impacts patients\u2019 quality of life. New therapeutic strategies and in particular biologic treatments are now available for these patients. It has been demonstrated that Dupilumab (an anti IL-4\/IL-13 biologic drug) is effective in reducing the size of nasal polyps and in improving patients\u2019 symptoms and thus, quality of life. No real-world studies examining Dupilamab\u2019s efficacy in the elderly with respect to other adult age groups have as yet been carried out. The aim of this multicentric study was to evaluate Dupilumab\u2019s efficacy in young\u2013middle adults as opposed to an older adult population affected by severe, uncontrolled CRSwNP. Of the 96 patients included in the study, 22 were 65 years old or older. Significant improvements were observed in all the parameters considered in both age groups after treatment was begun (T0 mean values for SNOT-22 = 58.5 \u00b1 20.3, VAS NO = 7.6 \u00b1 2.2, VAS smell = 8.6 \u00b1 2.1, NPS = 5.6 \u00b1 1.4, PNIF = 101.6 \u00b1 59.4, S\u2019S = 5.1 \u00b1 3.1), T4 mean values for SNOT-22 = 15.1 \u00b1 12.7, VAS NO = 1.7 \u00b1 1.8, VAS smell = 2.4 \u00b1 3, NPS = 1.7 \u00b1 1.7, PNIF = 162.4 \u00b1 43.2, S\u2019S = 10.4 \u00b1 3.7) (p &lt; 0.0001). No differences in the variables considered were observed between the two age groups during the study, with the exception of the Peak Nasal Inspiratory Flow (PNIF), which was marginally higher; this was also the case according to multivariate analyses (p = 0.008) in the young\u2013middle adult group with respect to the elderly one (p = 0.07). At multivariate analyses, asthma and the female sex negatively influenced the PNIF values (p = 0.001 and p = 0.012, respectively). Age negatively influenced the Visual Analog Scale (VAS) for nasal obstruction (p = 0.0032) and Endoscopic Sinus Surgery (ESS) negatively influenced the patents\u2019 olfactory performance (p = 0.028) to the same degree in both groups. Dupilumab was found to be effective to the same degree in both age groups. It can be considered a safe and reliable option for the treatment of elderly patients with severe, uncontrolled CRSwNP.<\/jats:p>","DOI":"10.3390\/jpm13081241","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T10:11:22Z","timestamp":1691662282000},"page":"1241","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Effectiveness of Dupilumab in the Treatment of Adult and Older Adult Patients with Severe, Uncontrolled CRSwNP"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2433-4761","authenticated-orcid":false,"given":"Giancarlo","family":"Ottaviano","sequence":"first","affiliation":[{"name":"Department of Neurosciences DNS, Otolaryngology Section, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-7018","authenticated-orcid":false,"given":"Eugenio","family":"De Corso","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Policlinico Gemelli University Hospital IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8349-9569","authenticated-orcid":false,"given":"Tommaso","family":"Saccardo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences DNS, Otolaryngology Section, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7101-1080","authenticated-orcid":false,"given":"Leandro Maria","family":"D\u2019Auria","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Policlinico Gemelli University Hospital IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonny","family":"Zampollo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences DNS, Otolaryngology Section, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2518-3435","authenticated-orcid":false,"given":"Giuseppe","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Policlinico Gemelli University Hospital IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Mairani","sequence":"additional","affiliation":[{"name":"Department of Neurosciences DNS, Otolaryngology Section, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"De Maio","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Policlinico Gemelli University Hospital IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9628-5164","authenticated-orcid":false,"given":"Bruno","family":"Scarpa","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences, University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6956-6227","authenticated-orcid":false,"given":"Christian","family":"Bacci","sequence":"additional","affiliation":[{"name":"Unit of Dentistry, Department of Neurosciences, University of Padua, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6221-4755","authenticated-orcid":false,"given":"Vittorio","family":"Favero","sequence":"additional","affiliation":[{"name":"Unit of Maxillofacial Surgery and Dentistry, Head and Neck Department, University of Verona, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.2147\/CIA.S279765","article-title":"Managing Chronic Rhinosinusitis with Nasal Polyps in the Elderly: Challenges and Solutions","volume":"17","author":"Merrill","year":"2022","journal-title":"Clin. Interv. Aging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1177\/1945892418807590","article-title":"Chronic Rhinosinusitis\u2014Could Phenotyping or Endotyping Aid Therapy?","volume":"33","author":"Cingi","year":"2019","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.otc.2010.04.003","article-title":"A Comprehensive Review of the Adverse Effects of Systemic Corticosteroids","volume":"43","author":"Poetker","year":"2010","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhin20.401","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2020","volume":"58","author":"Fokkens","year":"2020","journal-title":"Rhinology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ottaviano, G., De Corso, E., Cantone, E., Ciofalo, A., Saccardo, T., Bernardi, R., Mairani, E., Montuori, C., Roccuzzo, G., and Soldati, L. (2023). Measuring Nasal Patency and the Sense of Smell in CRSwNP Patients Treated with Dupilumab. J. Pers. Med., 13.","DOI":"10.3390\/jpm13020234"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"De Corso, E., Settimi, S., Montuori, C., Corb\u00f2, M., Passali, G.C., Porru, D.P., Lo Verde, S., Spanu, C., Penazzi, D., and Di Bella, G.A. (2022). Effectiveness of Dupilumab in the Treatment of Patients with Severe Uncontrolled CRSwNP: A \u201cReal-Life\u201d Observational Study in the First Year of Treatment. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102684"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ottaviano, G., Saccardo, T., Roccuzzo, G., Bernardi, R., Chicco, A.D., Pendolino, A.L., Scarpa, B., Mairani, E., and Nicolai, P. (2022). Effectiveness of Dupilumab in the Treatment of Patients with Uncontrolled Severe CRSwNP: A \u201cReal-Life\u201d Observational Study in Na\u00efve and Post-Surgical Patients. J. Pers. Med., 12.","DOI":"10.3390\/jpm12091526"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e153","DOI":"10.2500\/ajra.2016.30.4349","article-title":"Sinonasal Polyposis in the Elderly","volume":"30","author":"Brescia","year":"2016","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jaci.2012.07.047","article-title":"Omalizumab Is Effective in Allergic and Nonallergic Patients with Nasal Polyps and Asthma","volume":"131","author":"Gevaert","year":"2013","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/j.1749-4486.2009.01995.x","article-title":"Psychometric validity of the 22-item Sinonasal Outcome Test","volume":"34","author":"Hopkins","year":"2009","journal-title":"Clin. Otolaryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhin19.410","article-title":"European Position Paper on Diagnostic Tools in Rhinology","volume":"57","author":"Rimmer","year":"2019","journal-title":"Rhinology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/coa.13329","article-title":"Peak Nasal Inspiratory Flow Measurement and Visual Analogue Scale in a Large Adult Population","volume":"44","author":"Ottaviano","year":"2019","journal-title":"Clin. Otolaryngol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Whitcroft, K.L., Altundag, A., Balungwe, P., Boscolo-Rizzo, P., Douglas, R., Enecilla, M.L.B., Fjaeldstad, A.W., Fornazieri, M.A., Frasnelli, J., and Gane, S. (2023). Position paper on olfactory dysfunction: 2023. Rhinology, 16.","DOI":"10.4193\/Rhin22.483"},{"key":"ref_14","first-page":"32","article-title":"Peak Nasal Inspiratory Flow; Normal Range in Adult Population","volume":"44","author":"Ottaviano","year":"2006","journal-title":"Rhinology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"477","DOI":"10.2307\/2530872","article-title":"Two-Stage Analysis Based on a Mixed Model: Large-Sample Asymptotic Theory and Small-Sample Simulation Results","volume":"41","author":"Giesbrecht","year":"1985","journal-title":"Biometrics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1109\/TAC.1974.1100705","article-title":"A New Look at the Statistical Model Identification","volume":"19","author":"Akaike","year":"1974","journal-title":"IEEE Trans Automat. Contr."},{"key":"ref_17","unstructured":"R Core Team (2020). R: A Language and Environment for Statistical Computing 2020, R Foundation for Statistical Computing."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1016\/j.jaip.2018.01.034","article-title":"Conjunctivitis Occurring in Atopic Dermatitis Patients Treated with Dupilumab\u2013Clinical Characteristics and Treatment","volume":"6","author":"Wollenberg","year":"2018","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"538","DOI":"10.14639\/0392-100X-N2156","article-title":"A Prospective Study on the Efficacy of Dupilumab in Chronic Rhinosinusitis with Type 2 Inflammation","volume":"42","author":"Trimarchi","year":"2022","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1007\/s00405-013-2875-4","article-title":"Peak Nasal Inspiratory Flow: A Useful and Handy Tool for the Diagnosis of Nasal Obstruction in the Elderly","volume":"271","author":"Ottaviano","year":"2014","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1089\/fpsam.2020.0536","article-title":"Use of Functional Rhinoplasty in the Aging Nose: Medicare Database Analysis","volume":"24","author":"Were","year":"2022","journal-title":"Facial Plast. Surg. Aesthet. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1146\/annurev-physiol-021119-034610","article-title":"Aging and Lung Disease","volume":"82","author":"Cho","year":"2020","journal-title":"Annu. Rev. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1111\/j.1475-097X.2006.00683.x","article-title":"Nasal symptoms, airway obstruction and disease severity in chronic obstructive pulmonary disease","volume":"26","author":"Hurst","year":"2006","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_24","first-page":"200","article-title":"Does Peak Nasal Inspiratory Flow Relate to Peak Expiratory Flow?","volume":"46","author":"Ottaviano","year":"2008","journal-title":"Rhinology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s40520-015-0380-x","article-title":"Olfaction Deterioration in Cognitive Disorders in the Elderly","volume":"28","author":"Ottaviano","year":"2016","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2500\/ajra.2013.27.3879","article-title":"Olfactory Sensitivity and Sexual Desire in Young Adult and Elderly Men: An Introductory Investigation","volume":"27","author":"Ottaviano","year":"2013","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"178","DOI":"10.4193\/Rhino11.213","article-title":"Olfaction after Endoscopic Sinus Surgery: Long-Term Results","volume":"50","author":"Briner","year":"2012","journal-title":"Rhinol. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1097\/MLG.0b013e318170b5cb","article-title":"Olfactory Function Following Nasal Surgery","volume":"118","author":"Pade","year":"2008","journal-title":"Laryngoscope"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1126\/science.6505700","article-title":"Smell Identification Ability: Changes with Age","volume":"226","author":"Doty","year":"1984","journal-title":"Science"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"122","DOI":"10.4193\/Rhin17.168","article-title":"Comparison between unilateral PNIF and rhinomanometry in the evaluation of nasal cycle","volume":"56","author":"Pendolino","year":"2018","journal-title":"Rhinology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3367","DOI":"10.1007\/s00405-014-3456-x","article-title":"Endoglin (CD105) Expression in Sinonasal Polyposis","volume":"272","author":"Ottaviano","year":"2015","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_32","first-page":"351","article-title":"Influence of number of drugs on olfaction in the elderly","volume":"56","author":"Ottaviano","year":"2018","journal-title":"Rhinology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/194589240401800210","article-title":"Endoscopic Sinus Surgery in Geriatric Population","volume":"18","author":"Ramadan","year":"2004","journal-title":"Am. J. Rhinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/014556130108000411","article-title":"Endoscopic Sinus Surgery for the Treatment of Chronic Sinusitis in Geriatric Patients","volume":"80","author":"Jiang","year":"2001","journal-title":"Ear Nose Throat J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1002\/lary.24401","article-title":"Complications of Primary and Revision Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis","volume":"124","author":"Krings","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1007\/s00405-021-07063-2","article-title":"A Retrospective Study on Long-Term Efficacy of Intranasal Lysine-Aspirin in Controlling NSAID-Exacerbated Respiratory Disease","volume":"279","author":"Pendolino","year":"2022","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1177\/1945892419858582","article-title":"Relationship Between Nasal Cycle, Nasal Symptoms and Nasal Cytology","volume":"33","author":"Pendolino","year":"2019","journal-title":"Am. J. Rhinol. Allergy"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/8\/1241\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:30:04Z","timestamp":1760128204000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/8\/1241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,10]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["jpm13081241"],"URL":"https:\/\/doi.org\/10.3390\/jpm13081241","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,10]]}}}