Section: 
Rhinology issues
Rhinology issuesFine line between long-term remission of chronic rhinosinusitis with nasal polyps and recurrence
M. A. Budkovaya (1), S. A. Rebrova (2), Yu. K. Yanov (3), V. V. Dvoryanchikov (4), S. V. Ryazantsev (5)
(1), (2), (4), (5) Saint Petersburg Research Institute of Ear, Throat, Nose, and Speech, Saint Petersburg, 190013, Russian Federation, (1) Medical Institute of Saint Petersburg State University, Saint Petersburg, 199034, Russian Federation, (3) Kirov Military Medical Academy, Saint Petersburg, 194044, Russian Federation
UDK: УДК 616.211-006.5:615.37-036.66-036.87
DOI: https://doi.org/10.18692/1810-4800-2026-2-35-44
ABSTRACT
Abstract. Currently, biological therapy is an innovative and highly effective approach in the treatment of severe, non-controlled chronic rhinosinusitis with nasal polyps (CRSwNP) associated with T2-inflammation by standard treatment methods. The article presents a long-term follow-up of a patient who, 1 year after the start of targeted biological therapy with dupilumab, stopped treatment on his own due to complete relief of symptoms of rhinosinusitis with nasal polyps. Within 2 years after the abandonment of biological therapy, the patient had a persistent clinical remission in relation to the symptoms of CRSwNP, confirmed by the results of a video endoscopy of the nasal cavity, data of computed tomography of the paranasal sinuses. The trigger for the relapse of the polyposis process more than 2 years later was presumably an acute respiratory viral infection. Subsequently, due to the lack of response to basic therapy, dupilumab treatment was resumed. This clinical observation demonstrates that even prolonged remission after discontinuation of biological therapy does not eliminate the risk of late relapse, and viral infections can trigger the resumption of T2-mediated inflammation. The hypothesis of "tissue immunological memory," previously proposed in studies of dupilumab in patients with atopic dermatitis, may be of particular importance in triggering polyp relapse. These findings highlight the need for personalized approaches to the initiation and discontinuation of GEBT in PRS, an in-depth study of the criteria for a super response to treatment, and the importance of long-term patient monitoring even after achieving sustained remission.
Publication date:
15.04.2026
Keywords:
rhinosinusitis with nasal polyp, relapse, dupilumab, long-term remission, discontinuation For citation:
Budkovaya M. A., Rebrova S. A., Yanov Yu. K., Dvoryanchikov V. V., Ryazantsev S. V. Fine line between long-term remission of chronic rhinosinusitis with nasal polyps and recurrence. Russian Otorhinolaryngology. 2026;25(2):35-44. (In Russ.) https://doi.org/10.18692/1810-4800-2026-2-35-44