{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:10:19Z","timestamp":1793725819817,"version":"4.6.1"},"reference-count":22,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) and eosinophilic otitis media (EOM) are frequently co-existing eosinophilic disorders related to type 2 inflammation, which significantly impair the quality of life of patients. Dupilumab, a monoclonal antibody targeting the IL-4 receptor alpha and anti-IL-13, has demonstrated a promising profile of efficacy and safety in the treatment of CRSwNP; however, evidence on its role in concomitant EOM and CRSwNP remains limited in the literature. This study aims to evaluate the clinical efficacy of dupilumab in patients with concomitant CRSwNP and EOM over a six-month observational period. Materials and Methods: A retrospective observational cohort study was conducted on twenty-two patients (aged 18\u201375 years) over six months with severe uncontrolled CRSwNP and confirmed refractory EOM who were treated with dupilumab (300 mg every two weeks). Demographic data are collected, and outcome measures included Nasal Polyp Score (NPS), Sino-Nasal Outcome Test (SNOT-22), Visual Analog Scale for nasal congestion (VAS), tympanogram classification, and Chronic Otitis Media Outcome Test (COMOT-15), evaluated at baseline and 6 months. Results: Over the six-month treatment period, patients with coexisting CRSwNP and eosinophilic otitis media experienced significant improvements across the multiple validated clinical and patient-reported outcome measures. The Nasal Polyp Score (NPS) significantly decreased from a median of 5.7 (IQR: 1.2) at baseline to 1.5 (IQR: 1.3) at six months (p &lt; 0.0001). The SNOT-22 showed a substantial decline from a median of 77.6 (IQR: 19.0) to 21.5 (IQR: 13.4), p &lt; 0.0001. Visual Analog Scale (VAS) scores for nasal congestion improved significantly from 8.4 (IQR: 1.1) to 1.7 (IQR: 1.2), p &lt; 0.0001. Tympanogram scores improved from Tympanogram type \u201cB\u201d to Tympanogram type \u201cA\u201d (p = 0.018). COMOT-15 scale decreased from a median of 51.3 (IQR: 8.4) to 19.2 (IQR: 5.0) (p &lt; 0.0001). Peripheral eosinophil counts remained unchanged or increased (baseline 0.80 vs. 0.84 cells\/\u03bcL at six months, (p = 0.834)). Conclusions: Dupilumab treatment in patients with CRSwNP and EOM led to significant clinical improvements in sinonasal symptoms, middle ear function, and quality of life over six months, with no significant change in peripheral eosinophilia.<\/jats:p>","DOI":"10.3390\/medicina61081471","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T14:24:28Z","timestamp":1755267868000},"page":"1471","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy of Dupilumab in Patients with Chronic Rhinosinusitis with Nasal Polyps and Eosinophilic Otitis Media: A Six-Month Observational Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7226-4596","authenticated-orcid":false,"given":"Cosimo","family":"Galletti","sequence":"first","affiliation":[{"name":"Otorhinolaryngology Unit, \u201cOspedale Umberto I\u201d Enna, Faculty of Medicine and Surgery, Universit\u00e0 degli Studi di Enna \u201cKore\u201d, Contrada Ferrante, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Giammona Indaco","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Ospedale \u201cUmberto I\u201d Enna, Contrada Ferrante, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-8535","authenticated-orcid":false,"given":"Daniele","family":"Portelli","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8932-9045","authenticated-orcid":false,"given":"Giulia","family":"Laterra","sequence":"additional","affiliation":[{"name":"Cardiology Unit Umberto I Enna, Faculty of Medicine and Surgery, Universit\u00e0 degli Studi di Enna \u201cKore\u201d, Contrada Ferrante, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Zambito","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Ospedale \u201cUmberto I\u201d Enna, Contrada Ferrante, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Ferrisi","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Freni","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5115-6027","authenticated-orcid":false,"given":"Francesco","family":"Ciodaro","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5664-7493","authenticated-orcid":false,"given":"Francesco","family":"Freni","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Maira","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, \u201cOspedale Umberto I\u201d Enna, Faculty of Medicine and Surgery, Universit\u00e0 degli Studi di Enna \u201cKore\u201d, Contrada Ferrante, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Galletti","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology \u201cGaetano Barresi\u201d, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"ref_1","first-page":"1496","article-title":"Endotype-driven care pathways in patients with chronic rhinosinusitis","volume":"149","author":"Bachert","year":"2022","journal-title":"J. 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