Efficacy of Dupilumab in CRSwNP treatment: A systematic review and meta-analysis

Abstract Objective to evaluate efficacy of dupilumab in the treatment of CRSwNP. Background Chronic rhinosinusitis with nasal polyps (CRSwNP) represents an inflammation of the nasal and sinus mucosa, it is not uncommon disease. Patient with CRSwNP is presented nasal obstruction, facial pain, recurrent sinus infections, and anosmia. Dupilumab is an inhibitor of interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling pathways. Method A systematic review was conducted, strictly following the PRISMA guidelines. Search went through many databases including PubMed, Cochrane Library, Consensus, and Google scholar. 60 studies were acquired from the search and only four study included in this systematic review. Risk of biases were evaluated with acceptable results. Results Four studies included in this systematic review, primary outcomes including Lund-Mackay CT total score, Loss-of-smell score, Smell test (UPSIT) score, SNOT-22 total score, Bilateral endoscopic nasal polyp score, and Nasal congestion or obstruction score have shown a non-significant difference between placebo and dupilumab groups. Dupilumab group is associated. With higher level of blood eosinophils when compared with placebo group. Conclusion Dupilumab has shown a beneficial use in treating CRSwNP, its works on inhibiting the signaling pathways of interleukin-4 (IL-4) and interleukin-13 (IL-13).