A new real-world study from the Italian DUPIREAL network sheds light on how dupilumab, a biologic treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), affects blood eosinophil levels.
Researchers analyzed data from 564 patients with CRSwNP treated with dupilumab across 14 Italian centers. They defined dupilumab-induced blood eosinophilia (DIBE) as an absolute eosinophil count (AEC) increase of at least 50% from baseline (and >500 cells/mm³) or an AEC exceeding 1500 cells/mm³.
48% of patients developed dupilumab-induced blood eosinophilia (DIBE).
17% of patients experienced DIBE >1500.
On average, blood AEC peaked around 3 months into treatment and declined by 12 months.
DIBE was significantly more common in patients with comorbid asthma.
This large real-life cohort confirms that DIBE is a common but mostly transient phenomenon during dupilumab therapy for CRSwNP. It tends to occur early, resolve over time, and is more frequent in patients with type 2 inflammatory comorbidities like asthma or recent steroid exposure.
Although dupilumab-induced blood eosinophilia (DIBE) is predominantly transient, some exceptions have been identified.
If you're on dupilumab or considering it for CRSwNP, regular blood monitoring can help track these changes.
References:
https://www.jaci-inpractice.org/article/S2213-2198(25)01019-0/fulltext