Optimal Timing of Dupilumab Application in CRSwNP: Impact of “Neoadjuvant Therapy” on Surgical Outcomes at 1 Year

KEY POINTS: Preoperative neoadjuvant dupilumab (two doses) combined with full-house endoscopic sinus surgery (ESS) eliminates polyp recurrence at 12 months versus 50% recurrence in ESS-only cohort. Dupilumab-ESS cohort showed superior objective outcomes but comparable subjective symptom relief in this pilot study. "Neoadjuvant therapy" may reduce long-term biologic dependency and costs, while enabling sustained control with topical corticosteroids postoperatively.