A case of eosinophilic otitis media with successful symptomatic improvement in a patient treated with dupilumab: A case report and literature review

Eosinophilic otitis media (EOM) can be classified into three subtypes according to its clinical manifestations, with chronic otitis media with granulation (COMwG) being notably the most challenging to manage. In this paper, we report a case of a patient with COMwG who experienced successive failures with omalizumab (an anti-IgE monoclonal antibody) and benralizumab (anti-IL-5R) treatments, and whose ear symptoms were finally successfully improved by dupilumab (anti-IL-4R). Additionally, we collected 19 publications regarding the treatment of EOM with biological agents. These publications suggested that 32 patients with EOM were treated with anti-IgE monoclonal antibodies, among whom 14 patients (43.8%) responded. There were also 37 patients treated with anti-IL-5 or anti-IL-5R antibodies, with 24 patients (56.8%) showing a response. Regarding treatment with anti-IL-4R, which involved 24 patients, no reports of non-response to dupilumab have been found. Finally, our review observed that patients with the COMwG subtype responded well to dupilumab.