Journal Article Review Ppublish
PubMed: 40132672 DOI: 10.1016/j.jaci.2025.03.011
Clinical efficacy and mechanisms of biologics for chronic rhinosinusitis with nasal polyps.
J Allergy Clin Immunol 155(5):1401-1410
Authors: Radomir Kratchmarov, Tiffany Dharia, Kathleen Buchheit
Affiliations
- Division of Allergy and Clinical Immunology, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, and the Jeff and Penny Vinik Center, Boston, Mass.
- Division of Allergy and Clinical Immunology, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, and the Jeff and Penny Vinik Center, Boston, Mass.
Abstract
The management of chronic rhinosinusitis with nasal polyps (CRSwNP) can be challenging, particularly when standard treatments including intranasal corticosteroids and endoscopic sinus surgery do not result in adequate symptom control. CRSwNP is frequently characterized by a type 2 immune signature, and many patients have other comorbid type 2 conditions, including asthma. There are currently 3 biologic therapies approved for the treatment of CRSwNP-omalizumab, mepolizumab, and dupilumab-and there are promising therapies in development. Biologic therapies allow for improved patient quality of life in CRSwNP, reduction in need for systemic corticosteroid treatment and endoscopic sinus surgery, and improvement in treatment of comorbidities. Translational studies assessing how biologic therapies can modify inflammation in CRSwNP have allowed for a greater understanding of CRSwNP pathogenesis. We review CRSwNP clinical trial and real-world data on the effectiveness and safety of biologics, discuss their therapeutic mechanisms, assess outcomes of biologic therapy versus endoscopic sinus surgery, and discuss therapies in development and future directions.
MeSH
Omalizumab, Hypersensitivity, Adrenal Cortex Hormones, Polyps, Therapeutics, Biological Therapy, Nasal Polyps, Rhinosinusitis