The Therapeutic Role of Biologics in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP): A Review of the Current Evidence.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex inflammatory condition that is primarily categorized as either Type 2 (T2) or non-T2. The T2 inflammatory pathway plays a pivotal role in the pathogenesis of T2 CRSwNP. A significant proportion of patients do not respond to systemic glucocorticoid regimens or repeated surgical interventions, which severely impacts their long-term quality of life and presents a therapeutic challenge. Recent studies confirm that biologics are an effective treatment for severe or refractory CRSwNP. This review systematically collates the latest advances in biological therapies for CRSwNP by conducting extensive searches of the PubMed, Embase, and Cochrane Library databases from the inception of these databases up to October 2025. The review focuses on elucidating the pathological mechanisms of CRSwNP and the classification and target mechanisms of biologics. It also examines the current research landscape regarding variability in biologics efficacy. Substantial clinical evidence indicates that these biologics can effectively alleviate symptoms of sinusitis, reduce turbinate volume, and improve patients' quality of life. They also demonstrate potential in improving comorbid conditions, offering novel therapeutic options for severe or refractory CRSwNP. However, challenges remain in identifying biomarkers and selecting suitable biologics, requiring further research to enable personalized treatment strategies.