{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:14:36Z","timestamp":1760145276739,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"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>Recalcitrant frontal sinusitis in patients with chronic rhinosinusitis and nasal polyps (CRSwNP) has a negative impact on their quality of life due to frontal pain and a high risk of sinus occlusion, thus necessitating antibiotics, systemic corticosteroids, and multiple surgeries. The aim of this study was to assess the efficacy of dupilumab in reducing frontal pain and the need for rescue treatments for recalcitrant frontal sinusitis in patients with CRSwNP. We enrolled a cohort of 10 patients with severe uncontrolled CRSwNP and concomitant recurrent frontal sinusitis associated with severe facial pain measured by MIDAS score who were treated with dupilumab 300 mg every 2 weeks and followed for at least 12 months. The mean MIDAS score decreased from 45.6 \u00b1 10.7 at baseline to 1.3 \u00b1 2.3 at 6 months (p &lt; 0.05). VAS craniofacial pain decreased from 7.3 \u00b1 1.6 at baseline to 1.2 \u00b1 1.5 at 6 months (p &lt; 0.05). No patient needed oral corticosteroids during treatment with dupilumab (p &lt; 0.05), and the use of analgesics decreased from 9.6 \u00b1 3.1 NSAID pills\/week in the last 2 months at baseline to 0.6 \u00b1 1.3 at 1 year of follow-up (p &lt; 0.05). Our results demonstrated that use of subcutaneous dupilumab can improve symptom control, including recurrent severe cranio-facial pain, and reduce the need for rescue medical treatments (systemic steroids and NSAID) in patients with severe uncontrolled CRSwNP and concomitant recurrent frontal sinusitis.<\/jats:p>","DOI":"10.3390\/jpm14070735","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T11:17:09Z","timestamp":1720523829000},"page":"735","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dupilumab Improves Facial Pain and Reduces Rescue Treatments in Patients with CRSwNP and Recalcitrant Frontal Sinusitis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-7018","authenticated-orcid":false,"given":"Eugenio","family":"De Corso","sequence":"first","affiliation":[{"name":"Unit of Otorhinolaryngology and Head-Neck Surgery, \u201cA. Gemelli\u201d University Hospital Foundation IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0104-1501","authenticated-orcid":false,"given":"Stefano","family":"Settimi","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology and Head-Neck Surgery, \u201cA. Gemelli\u201d University Hospital Foundation IRCCS, 00168 Rome, Italy"},{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Penazzi","sequence":"additional","affiliation":[{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Corb\u00f2","sequence":"additional","affiliation":[{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6111-0786","authenticated-orcid":false,"given":"Mario","family":"Rigante","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology and Head-Neck Surgery, \u201cA. Gemelli\u201d University Hospital Foundation IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-0314","authenticated-orcid":false,"given":"Claudio","family":"Montuori","sequence":"additional","affiliation":[{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9826-0517","authenticated-orcid":false,"given":"Alberta","family":"Rizzuti","sequence":"additional","affiliation":[{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Clara","family":"Pacilli","sequence":"additional","affiliation":[{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Di Cesare","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology and Head-Neck Surgery, \u201cA. Gemelli\u201d University Hospital Foundation IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Lo Verde","sequence":"additional","affiliation":[{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6795-746X","authenticated-orcid":false,"given":"Angela","family":"Rizzi","sequence":"additional","affiliation":[{"name":"Unit of Allergology e Clinical Immunology, \u201cA. Gemelli\u201d Hospital Foundation IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaella","family":"Chini","sequence":"additional","affiliation":[{"name":"Unit of Allergology e Clinical Immunology, \u201cA. Gemelli\u201d Hospital Foundation IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacopo","family":"Galli","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology and Head-Neck Surgery, \u201cA. Gemelli\u201d University Hospital Foundation IRCCS, 00168 Rome, Italy"},{"name":"Department of Head-Neck and Sensory Organs, Catholic University of Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14639\/0392-100X-N1614","article-title":"Biologics for Severe Uncontrolled Chronic Rhinosinusitis with Nasal Polyps: A Change Management Approach. Consensus of the Joint Committee of Italian Society of Otorhinolaryngology on Biologics in Rhinology","volume":"42","author":"Bellocchi","year":"2022","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"De Corso, E., Baroni, S., and Settimi, S. (2022). Sinonasal Biomarkers Defining Type 2-High and Type 2-Low Inflammation in Chronic Rhinosinusitis with Nasal Polyps. J. Pers. Med., 12.","DOI":"10.3390\/jpm12081251"},{"key":"ref_3","first-page":"1","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2020","volume":"20","author":"Fokkens","year":"2020","journal-title":"Rhinology"},{"key":"ref_4","first-page":"126","article-title":"Long-Term Outcomes of Different Endoscopic Sinus Surgery in Recurrent Chronic Rhinosinusitis with Nasal Polyps and Asthma","volume":"58","author":"Zhang","year":"2020","journal-title":"Rhinology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1002\/lary.26391","article-title":"Prevalence of Polyp Recurrence after Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyposis","volume":"127","author":"DeConde","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1177\/019459989210600409","article-title":"Transantral Revision of Recurrent Maxillary and Ethmoidal Disease Following Functional Intranasal Surgery","volume":"106","author":"Friedman","year":"1992","journal-title":"Otolaryngol. Head. Neck Surg."},{"key":"ref_7","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-24 and LIBERTY NP SINUS-52): Results from Two Multicentre, Randomised, Double-Blind, Placebo-Controlled, Parallel-Group Phase 3 Trials","volume":"394","author":"Bachert","year":"2019","journal-title":"Lancet"},{"key":"ref_8","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-life Study (DUPIREAL)","volume":"78","author":"Pasquini","year":"2023","journal-title":"Allergy"},{"key":"ref_9","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_10","doi-asserted-by":"crossref","first-page":"113","DOI":"10.14639\/0392-100X-N0364","article-title":"Prognostic Value of the Sinonasal Outcome Test 22 (SNOT-22) in Chronic Rhinosinusitis","volume":"40","author":"Gallo","year":"2020","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/2045-7022-1-2","article-title":"Diagnostic Tools in Rhinology EAACI Position Paper","volume":"1","author":"Scadding","year":"2011","journal-title":"Clin. Transl. Allergy"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1365-2222.1988.tb02840.x","article-title":"Symptom Scores as Measures of the Severity of Rhinitis","volume":"18","author":"Linder","year":"1988","journal-title":"Clin. Exp. Allergy"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.healthpol.2004.02.008","article-title":"Measuring Health Status: Information for Primary Care Decision Making","volume":"71","author":"Kind","year":"2005","journal-title":"Health Policy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s00405-021-06848-9","article-title":"Smell Impairment in Patients with Chronic Rhinosinusitis: A Real-Life Study","volume":"279","author":"Passali","year":"2022","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s00405-006-0173-0","article-title":"Normative Data for the \u201cSniffin\u2019 Sticks\u201d Including Tests of Odor Identification, Odor Discrimination, and Olfactory Thresholds: An Upgrade Based on a Group of More than 3000 Subjects","volume":"264","author":"Hummel","year":"2007","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1212\/WNL.56.suppl_1.S20","article-title":"Development and Testing of the Migraine Disability Assessment (MIDAS) Questionnaire to Assess Headache-Related Disability","volume":"56","author":"Stewart","year":"2001","journal-title":"Neurology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1002\/alr.21519","article-title":"Nasal Lavage Levels of Granulocyte-Macrophage Colony-Stimulating Factor and Chronic Nasal Hypereosinophilia","volume":"5","author":"Baroni","year":"2015","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1007\/s00405-010-1233-z","article-title":"Extensive Endoscopic Sinus Surgery: Does This Reduce the Revision Rate for Nasal Polyposis?","volume":"267","author":"Masterson","year":"2010","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/lio2.27","article-title":"Factors Affecting Revision Rate of Chronic Rhinosinusitis","volume":"1","author":"Koskinen","year":"2016","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/j.1365-2559.2005.02310.x","article-title":"Wound Healing after Paranasal Sinus Surgery: Neutrophilic Inflammation Influences the Outcome","volume":"48","author":"Watelet","year":"2006","journal-title":"Histopathology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/alr.21738","article-title":"The International Frontal Sinus Anatomy Classification (IFAC) and Classification of the Extent of Endoscopic Frontal Sinus Surgery (EFSS)","volume":"6","author":"Wormald","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1002\/alr.21739","article-title":"Outcomes of Modified Endoscopic Lothrop in Aspirin-Exacerbated Respiratory Disease with Nasal Polyposis","volume":"6","author":"Morrissey","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_23","first-page":"462","article-title":"Effectiveness of the Lateral Pedicled Endonasal Flap for Prevention of Restenosis in Frontal Sinus Drillouts","volume":"60","author":"Fischer","year":"2022","journal-title":"Rhin"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2500\/ajra.2016.30.4271","article-title":"Extensive versus Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyps and Asthma: A 1-Year Study","volume":"30","author":"Chen","year":"2016","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_25","first-page":"7482","article-title":"Use of Balloon Catheter Dilation and Steroid-Eluting Stent in Light and Severe Rhinosinusitis of Frontal Sinus: A Multicenter Retrospective Randomized Study","volume":"22","author":"Minni","year":"2018","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2659","DOI":"10.1002\/lary.26140","article-title":"Randomized Controlled Trial of a Bioabsorbable Steroid-releasing Implant in the Frontal Sinus Opening","volume":"126","author":"Smith","year":"2016","journal-title":"Laryngoscope"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/alr.20020","article-title":"Safety and Efficacy of a Novel Bioabsorbable, Steroid-eluting Sinus Stent","volume":"1","author":"Murr","year":"2011","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.alit.2024.02.002","article-title":"Efficacy of Dupilumab for Airway Hypersecretion and Airway Wall Thickening in Patients with Moderate-to-Severe Asthma: A Prospective, Observational Study","volume":"73","author":"Tajiri","year":"2024","journal-title":"Allergol. Int."},{"key":"ref_29","first-page":"e55884","article-title":"Successful Treatment of Mucus Plug Due to Allergic Bronchopulmonary Aspergillosis Using Dupilumab","volume":"16","author":"Sumi","year":"2024","journal-title":"Cureus"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.1002\/lary.31238","article-title":"Radiological Versus Clinical 1-Year Outcomes of Dupilumab in Refractory CRSwNP: A Real-Life Study","volume":"134","author":"Giombi","year":"2024","journal-title":"Laryngoscope"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1080\/1744666X.2023.2218617","article-title":"Evaluation of Switching or Simultaneous Use of Biologic Treatment in Patients with Severe Chronic Rhinosinusitis with Nasal Polyps and Severe Asthma. Considerations in Clinical Decision Making","volume":"19","author":"Otten","year":"2023","journal-title":"Expert. Rev. Clin. Immunol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/7\/735\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:12:02Z","timestamp":1760109122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/7\/735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,9]]},"references-count":31,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jpm14070735"],"URL":"https:\/\/doi.org\/10.3390\/jpm14070735","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2024,7,9]]}}}