[Biological therapy in the inflammatory disorders of the upper airway: the endotype-driven treatment of chronic rhinosinusitis].

Patients with difficult-to-treat chronic bilateral rhinosinusitis with nasal polyps - a type 2 inflammatory endotype - who are resistant to conventional medical and surgical therapy exhibit prolonged and not controlled symptoms. Quality of life, daily activities and sleeping are severely affected. Symptomatic, etiopathologic, surgical and general antiinflammatory (systemic steroid) therapeutic options of the past decades have not been sufficient enough in the treatment of refractory chronic rhinosinusitis. The new therapy with humanized monoclonal antibodies directed against the most relevant mediators and effector cells resulted in outstanding impovements in this field. Other type 2 manifestations may also be effectively treated at the same time, which improves the quality of life and is considered cost-effective as well. The author summarizes the actual etiopathogenic and clinical implications, the approved and available biologics, the related evidences and the preliminary clinical experiences. Orv Hetil. 2023; 164(18): 694-701.