Current opinion in otolaryngology & head and neck surgery · 2025
Appropriate use of biologics in management of chronic rhinosinusitis with nasal polyposis.
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Fischer Jakob L, Lee Jivianne T
Аннотация
PURPOSE OF REVIEW: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a common yet complex and heterogeneous inflammatory condition that can be refractory to standard medical and surgical treatment. Patients with refractory disease may be candidates for biologics, medications that specifically target the biomarkers associated with sinonasal inflammation. The purpose of this review is to review the current literature regarding the appropriate use of biologics in the management of CRSwNP.
RECENT FINDINGS: There are three currently approved biologics in the management of CRSwNP, dupilumab, omalizumab, and mepolizumab. Each biologic has demonstrated clinical efficacy in the management of CRSwNP. Current guidelines from multiple professional institutions recommend considering biologics in patients with refractory CRSwNP who have either undergone or are unable to undergo sinus surgery. Patients should be monitored closely for biologic-related adverse events and treatment response 6 months after therapy should be assessed. In poor responders to biologic therapy, alternative biologics or revision surgery can be considered.
SUMMARY: Biologic therapy has demonstrated efficacy in the management of CRSwNP that is refractory to standard medical and surgical therapy and may be a good treatment option in this patient population.
RECENT FINDINGS: There are three currently approved biologics in the management of CRSwNP, dupilumab, omalizumab, and mepolizumab. Each biologic has demonstrated clinical efficacy in the management of CRSwNP. Current guidelines from multiple professional institutions recommend considering biologics in patients with refractory CRSwNP who have either undergone or are unable to undergo sinus surgery. Patients should be monitored closely for biologic-related adverse events and treatment response 6 months after therapy should be assessed. In poor responders to biologic therapy, alternative biologics or revision surgery can be considered.
SUMMARY: Biologic therapy has demonstrated efficacy in the management of CRSwNP that is refractory to standard medical and surgical therapy and may be a good treatment option in this patient population.