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Review
. 2021 Jul 12:14:873-882.
doi: 10.2147/JAA.S258438. eCollection 2021.

Management of Chronic Rhinosinusitis with Nasal Polyposis in the Era of Biologics

Justin C Morse  1 , Craig Miller  1 , Brent Senior  1
Affiliations
Review

Management of Chronic Rhinosinusitis with Nasal Polyposis in the Era of Biologics

Justin C Morse et al. J Asthma Allergy. .

Abstract

Purpose of review: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a phenotypic designation of the broader condition of chronic rhinosinusitis. The advent of targeted biologics has shown promise in targeting different aspects of the inflammatory pathway, yet there remains a lack of consensus on the correct timing and use of these medications. This review seeks to provide a concise update of the available literature on the pathophysiology of CRSwNP, the evolution and cost utility of biologics as it pertains to management of patients with CRSwNP, and evidence for each available biologic and its use in CRSwNP.

Recent findings: There are two biologics with FDA approval for use in CRSwNP: dupilumab and omalizumab. Recent clinical trials of other biologic therapies targeting type 2 inflammatory pathways have also demonstrated efficacy both in symptom scores and nasal polyp reduction. However, studies have questioned the cost utility of these medications compared to other interventions. Furthermore, timing of use with respect to other interventions including surgery remains challenging.

Keywords: biologics; chronic rhinosinusitis with nasal polyposis; management of nasal polyps; nasal polyps.

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Conflict of interest statement

Brent Senior is the Vice President for Development and Strategy for the American Rhinologic Society. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Algorithm proposed by authors for use of biologics in the management of chronic rhinosinusitis with nasal polyps.
See this image and copyright information in PMC

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