Laryngoscope investigative otolaryngology · 2026
Association Between Biologic Therapy and Reduced Acute Rhinosinusitis Episodes: A Retrospective Database Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Zheng Wynne, Arslan Maeen, Zhu Christina, Guirguis Christopher, Spielman Daniel B
Аннотация
OBJECTIVE: To assess whether biologics (dupilumab, mepolizumab, and omalizumab) used for conditions other than chronic rhinosinusitis with nasal polyps (CRSwNP) reduce the frequency of acute bacterial rhinosinusitis (ABRS) episodes.
METHODS: This retrospective cohort study utilized the All of Us Research Program database to identify patients treated with dupilumab, mepolizumab, or omalizumab, excluding those with CRSwNP. A control group matched by race, gender, and comorbidities (asthma, allergic rhinitis, atopic dermatitis, smoking status) was created using propensity score matching (1:1 ratio) and K-nearest neighbors. The primary outcome was the frequency of ABRS episodes in biologic-exposed versus control groups, analyzed using χ2 tests to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS: Out of 2094 subjects, the biologic group had a significantly lower ABRS rate (6%) compared to controls (14%) (OR 0.4349, p < 0.0001). Dupilumab use was associated with the greatest significant reduction in ABRS risk (OR 0.1526, p < 0.001044). Mepolizumab (OR 0.6027, p = 1) and omalizumab (OR 0.7671, p = 0.4133) showed a decrease in ABRS episodes though this finding was not statistically significant.
CONCLUSION: Dupilumab appears to significantly reduce ABRS episodes in patients without CRSwNP, suggesting a protective effect on sinonasal health even in patients without chronic sinusitis. Further studies are needed to confirm these effects and to evaluate risks associated with long-term biologic use in non-CRSwNP populations.
LEVEL OF EVIDENCE: IIIb/IV.
METHODS: This retrospective cohort study utilized the All of Us Research Program database to identify patients treated with dupilumab, mepolizumab, or omalizumab, excluding those with CRSwNP. A control group matched by race, gender, and comorbidities (asthma, allergic rhinitis, atopic dermatitis, smoking status) was created using propensity score matching (1:1 ratio) and K-nearest neighbors. The primary outcome was the frequency of ABRS episodes in biologic-exposed versus control groups, analyzed using χ2 tests to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS: Out of 2094 subjects, the biologic group had a significantly lower ABRS rate (6%) compared to controls (14%) (OR 0.4349, p < 0.0001). Dupilumab use was associated with the greatest significant reduction in ABRS risk (OR 0.1526, p < 0.001044). Mepolizumab (OR 0.6027, p = 1) and omalizumab (OR 0.7671, p = 0.4133) showed a decrease in ABRS episodes though this finding was not statistically significant.
CONCLUSION: Dupilumab appears to significantly reduce ABRS episodes in patients without CRSwNP, suggesting a protective effect on sinonasal health even in patients without chronic sinusitis. Further studies are needed to confirm these effects and to evaluate risks associated with long-term biologic use in non-CRSwNP populations.
LEVEL OF EVIDENCE: IIIb/IV.