Clinical management of dupilumab-induced blood eosinophilia in CRSwNP: a practical algorithm
Bibliographic record
Abstract
Dupilumab is widely recognised as a highly effective therapy for severe chronic rhinosinusitis with nasal polyps (CRSwNP). A rise in blood eosinophil count (BEC) might occur during treatment across all approved indications. In CRSwNP, dupilumab-induced blood eosinophilia (DIBE) is typically of early onset, transient, and asymptomatic without impairing the drug’s efficacy. A review including data from 11 clinical trials on all approved dupilumab indications reported eosinophilia-related clinical manifestations in only 7 of 4,666 patients receiving dupilumab. Real-world studies confirm DIBE is largely benign, with only rare AEs requiring dupilumab discontinuation such as eosinophilic pneumonia, especially in eosinophilic granulomatosis with polyangiitis (EGPA) patients. Such exceedingly rare events were mainly described within the first months of treatment, however late onset DIBE (after 6 months) has also been detected, especially in patients dependent on systemic corticosteroids.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.005 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".