Biologic Treatments for Chronic Rhinosinusitis With Nasal Polyps (CRSwNP): A Comparative Review of Efficiency and Risks.

Abstract

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition of the nasal passages and sinuses, often characterized by nasal congestion, loss of smell, facial pressure, and nasal discharge. Conventional treatments, such as corticosteroids and endoscopic sinus surgery (ESS), often provide only temporary relief, with frequent recurrence of symptoms. For patients with severe, refractory CRSwNP, biologic therapies have emerged as a promising treatment option. This review evaluates the efficacy and safety of biologic treatments for CRSwNP, including dupilumab, mepolizumab, and omalizumab. We analyze clinical trial data, patient-reported outcomes, and the latest research on the use of biologics in CRSwNP management. Our findings confirm the efficacy of biologics in treating CRSwNP, showing consistent improvements in both clinical and patient-reported outcomes. The use of biologics resulted in a significant reduction in nasal polyp size, improved nasal congestion, and reduced the need for further surgery or systemic corticosteroids. Moreover, patients experienced an improved sense of smell and a better quality of life. This review also includes a comparative analysis of the three biologics, highlighting their efficiency and potential risks. The findings suggest that dupilumab may be the most effective biologic therapy for CRSwNP, showing superior efficacy compared to mepolizumab and omalizumab in reducing nasal polyp size and improving nasal congestion. The article provides valuable insights for healthcare providers and patients considering biologic therapy for CRSwNP, emphasizing the importance of personalized treatment decisions based on individual patient factors, including disease severity, comorbidities, and preferences.