(0900) A Case Series on the Use of Dupilumab for Treatment of Eosinophilic Otitis Media

Introduction: Eosinophilic otitis media (EOM) is a chronic intractable otitis media with highly viscous middle ear effusion containing numerous eosinophils. and the most effective treatment for patients with EOM is recognized to use systemic or topical steroids. However, systemic steroid treatment has various side effects, there’s a limitation to use it in long term treatment or to treat patients with diabetes. Recently, we have experienced 6 cases of EOM treated with dupilumab that had improvement in otologic symptoms including otorrhea and hearing loss.

Methods: This case series study is based on retrospective clinical data from six EOM patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRScNPs) who were treated with dupilumab. The patients included 2 females and 4 males, aged 41 to 75 at the first visit. They all had asthma and five patients had a history of undergoing endoscopic sinus surgery (ESS) due to CRScNPs. Of the patients, 4 had tympanic membrane perforation, and rest of them had a middle ear effusion. Another 3 patients had a history of receiving ventilation tube insertion. They all had highly viscous middle ear effusion or ear fullness, asthma, and nasal polyposis which is not resolved to conventional treatment.

Results: All of patients showed improvement in symptoms of viscous otorrhea or ear fullness, and could be weaned from systemic corticosteroid therapy or intratympanic dexamethasone injection. Additionally, 3 patients reported improvement in hearing. Some patients showed improvement in asthma symptoms or hyposmia, and nasal polyp size deceased.

Conclusions: This case series demonstrated that the use of dupilumab in EOM can be effective in improving symptoms control and reducing corticosteroid therapy when treating coexisting asthma and/or CRScNP.