Bucher indirect treatment comparison of phase 3 trials with dupilumab and tezepelumab in chronic rhinosinusitis with nasal polyps

TY - JOUR

T1 - Bucher indirect treatment comparison of phase 3 trials with dupilumab and tezepelumab in chronic rhinosinusitis with nasal polyps

AU - Suter, Philipp

AU - Greig, Robert

AU - Lipworth, Brian J

N1 - Publisher Copyright: © 2026 The Authors.

PY - 2026/1/22

Y1 - 2026/1/22

N2 - Background Biologic therapies significantly affect clinical outcomes in patients with chronic rhinosinusitis with nasal polyps (CRSwNPs), including those with comorbid asthma. Tezepelumab and dupilumab act on upstream and downstream type 2 cytokine pathways, respectively. Objective To indirectly compare the relative efficacy of dupilumab with tezepelumab based on phase 3 randomized controlled trials in CRSwNP, including those with comorbid asthma. Methods A Bucher indirect head-to-head comparison of studies evaluating dupilumab and tezepelumab for relevant outcomes was performed. Results Dupilumab and tezepelumab demonstrated comparable significant improvements in endoscopic-, radiologic-, olfactory-, and symptom-based outcomes in CRSwNP. Relative differences in hazard ratios for use of oral corticosteroids and/or surgery favored tezepelumab. However, no differences were observed when considering absolute values. Dupilumab demonstrated superiority in patients with comorbid asthma for symptom control. Conclusion Indirect treatment comparison revealed comparable overall clinical benefits of dupilumab and tezepelumab in CRSwNP. However, a prospective head-to-head randomized controlled trial would be needed to confirm their relative efficacy.

AB - Background Biologic therapies significantly affect clinical outcomes in patients with chronic rhinosinusitis with nasal polyps (CRSwNPs), including those with comorbid asthma. Tezepelumab and dupilumab act on upstream and downstream type 2 cytokine pathways, respectively. Objective To indirectly compare the relative efficacy of dupilumab with tezepelumab based on phase 3 randomized controlled trials in CRSwNP, including those with comorbid asthma. Methods A Bucher indirect head-to-head comparison of studies evaluating dupilumab and tezepelumab for relevant outcomes was performed. Results Dupilumab and tezepelumab demonstrated comparable significant improvements in endoscopic-, radiologic-, olfactory-, and symptom-based outcomes in CRSwNP. Relative differences in hazard ratios for use of oral corticosteroids and/or surgery favored tezepelumab. However, no differences were observed when considering absolute values. Dupilumab demonstrated superiority in patients with comorbid asthma for symptom control. Conclusion Indirect treatment comparison revealed comparable overall clinical benefits of dupilumab and tezepelumab in CRSwNP. However, a prospective head-to-head randomized controlled trial would be needed to confirm their relative efficacy.

KW - chronic rhinosinusitis with nasal polyps

KW - asthma

KW - type 2 inflammation

KW - biologics

KW - dupilumab

KW - tezepelumab

KW - Bucher

U2 - 10.1016/j.anai.2026.01.011

DO - 10.1016/j.anai.2026.01.011

M3 - Article

SN - 1081-1206

JO - Annals of Allergy, Asthma and Immunology

JF - Annals of Allergy, Asthma and Immunology

ER -