Update on Biologics in Treatment of Chronic Rhinosinusitis With Nasal Polyposis

Abstract

Chronic rhinosinusitis is a common chronic inflammatory condition of sinonasal cavities and occurs with or without nasal polyps. Uncontrolled chronic rhinosinusitis with nasal polyp (CRSwNP) has a negative impact on an individual’s quality of life. Many studies have been conducted for novel treatments targeting type 2 cytokines involved in CRSwNP such as interleukin (IL)-4, IL-5, IL-13 and immunoglobulin E. Biologics have recently been proven to improve the nasal symptoms of CRSwNP and reduce the need for systemic glucocorticosteroids. Recently dupilumab, omalizumab and mepolizumab were approved by Food and Drug Administration for CRSwNP, and other biologics are under investigation. Large-scale and longterm clinical trials are needed for therapeutic effectiveness, and several questions remain regarding patient selection, treatment algorithm, and cost-effectiveness. Nevertheless, emerging biologics may offer a new therapeutic option for uncontrolled CRSwNP.