Chinese Position Paper on Biologic Therapy for Chronic Rhinosinusitis With Nasal Polyps

Mu Xian^{1

2

3}, Bing Yan^{1

2

3}, Xicheng Song⁴, Jianjun Chen⁵, Jun Tang⁶, Yan Jiang⁷, Lijia Wan⁸, Wen Liu⁹, Jinmei Xue¹⁰, Zhiwei Cao¹¹, Yafeng Yu¹², Xiangli Yang¹³, Li Shi¹⁴, Guangke Wang¹⁵, Yu Xu¹⁶, Yucheng Yang¹⁷, Jing Ye¹⁸, Luyun Jiang¹⁹, Fang Quan²⁰, Guolin Tan²¹, Feng Liu²², Zhendong Xu²³, Xiaowen Zhang²⁴, Jiping Li²⁵, Lizhong Su²⁶, Yi Yang²⁷, Jiangang Fan²⁸, Gang He²⁸, Li Zhu²⁹, Xiangdong Wang^{1

2

3}, Ming Wang^{1

2

3}, Shen Shen^{1

2

3}, Jian Li^{30

31}, Huabin Li³², Xin Wei³³, Hongmeng Yu³⁴, Zheng Liu³⁵, Ruixia Ma³⁶, Huanhai Liu³⁷, Jianfeng Liu³⁸, Wei Lv³⁹, Qintai Yang⁴⁰, Dongdong Zhu⁴⁰, Lei Cheng⁴¹, Chengshuo Wang^{1

2

3}, Luo Zhang^{1

2

3}

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
² Beijing Institute of Otolaryngology, Beijing Laboratory of Allergic Diseases, Beijing Key Laboratory of New Medicine and Diagnostic Technology Research for Nasal Disease, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China.
³ Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.
⁴ Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China.
⁵ Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
⁶ Otolaryngology Department, The First People's Hospital, Foshan, Guangdong, China.
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
⁸ Department of Otorhinolaryngology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China.
⁹ Department of Otorhinolaryngology, Zibo Central Hospital, Zibo, Shandong, China.
¹⁰ Department of Otorhinolaryngology, Head and Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
¹¹ Department of Otolaryngology-Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
¹² Department of Otolaryngology Head & Neck Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
¹³ Department of Otolaryngology Head and Neck Surgery, Tianjin Union Medical Center, Tianjin, China.
¹⁴ Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China.
¹⁵ Department of Otolaryngology, Head and Neck Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
¹⁶ Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Centre, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
¹⁷ Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
¹⁸ Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
¹⁹ Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
²⁰ Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China.
²¹ Department of Otorhinolaryngology, Head and Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
²² Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital Sichuan University, Chengdu, Sichuan, China.
²³ E.N.T. Department, Baotou Central Hospital, Baotou, Inner Mongolia Autonomous Region, China.
²⁴ Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
²⁵ Department of Otolaryngology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
²⁶ Department of Otolaryngology, Centre of Otolaryngology Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, Hangzhou, China.
²⁷ Otolaryngology Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
²⁸ Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
²⁹ Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China.
³⁰ Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
³¹ Guangxi Hospital Division, Of the First Affiliated Hospital, Sun Yat-Sen University, Nanning, Guangxi, China.
³² Allergy Center, Department of Otolaryngology, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.
³³ Department of Otorhinolaryngology Head and Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.
³⁴ ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
³⁵ Department of Otolaryngology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
³⁶ The Department of Otorhinolaryngology Head and Neck Surgery, The First People's Hospital of Yinchuan, Yinchuan, Ningxia, China.
³⁷ Department of Otolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China.
³⁸ Department of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, China.
³⁹ Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴⁰ Department of Otolaryngology, Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁴¹ Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.

PMID: 40042059
PMCID: PMC12105070
DOI: 10.1111/all.16519

Review

Chinese Position Paper on Biologic Therapy for Chronic Rhinosinusitis With Nasal Polyps

Mu Xian et al. Allergy. 2025 May.

. 2025 May;80(5):1208-1225.

doi: 10.1111/all.16519. Epub 2025 Mar 5.

Authors

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
² Beijing Institute of Otolaryngology, Beijing Laboratory of Allergic Diseases, Beijing Key Laboratory of New Medicine and Diagnostic Technology Research for Nasal Disease, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China.
³ Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China.
⁴ Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China.
⁵ Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
⁶ Otolaryngology Department, The First People's Hospital, Foshan, Guangdong, China.
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
⁸ Department of Otorhinolaryngology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China.
⁹ Department of Otorhinolaryngology, Zibo Central Hospital, Zibo, Shandong, China.
¹⁰ Department of Otorhinolaryngology, Head and Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
¹¹ Department of Otolaryngology-Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
¹² Department of Otolaryngology Head & Neck Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
¹³ Department of Otolaryngology Head and Neck Surgery, Tianjin Union Medical Center, Tianjin, China.
¹⁴ Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China.
¹⁵ Department of Otolaryngology, Head and Neck Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
¹⁶ Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Centre, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
¹⁷ Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
¹⁸ Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
¹⁹ Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
²⁰ Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China.
²¹ Department of Otorhinolaryngology, Head and Neck Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
²² Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital Sichuan University, Chengdu, Sichuan, China.
²³ E.N.T. Department, Baotou Central Hospital, Baotou, Inner Mongolia Autonomous Region, China.
²⁴ Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
²⁵ Department of Otolaryngology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
²⁶ Department of Otolaryngology, Centre of Otolaryngology Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, Hangzhou, China.
²⁷ Otolaryngology Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
²⁸ Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
²⁹ Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China.
³⁰ Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
³¹ Guangxi Hospital Division, Of the First Affiliated Hospital, Sun Yat-Sen University, Nanning, Guangxi, China.
³² Allergy Center, Department of Otolaryngology, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China.
³³ Department of Otorhinolaryngology Head and Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.
³⁴ ENT Institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
³⁵ Department of Otolaryngology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
³⁶ The Department of Otorhinolaryngology Head and Neck Surgery, The First People's Hospital of Yinchuan, Yinchuan, Ningxia, China.
³⁷ Department of Otolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Naval Medical University, Naval Medical University, Shanghai, China.
³⁸ Department of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, China.
³⁹ Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁴⁰ Department of Otolaryngology, Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁴¹ Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.

PMID: 40042059
PMCID: PMC12105070
DOI: 10.1111/all.16519

Abstract

Emerging biologics that selectively target key cytokines present a promising therapeutic alternative for patients suffering from severe, uncontrollable chronic rhinosinusitis with nasal polyps (CRSwNP). Despite the limited availability of registered biologics for CRSwNP treatment in China, the country is experiencing rapid development in this field. It is imperative to standardize the application of biologic agents in CRSwNP management in preparation for their future integration into the CRSwNP care pathway. The Rhinology Group, Chinese Society of Otorhinolaryngology-Head and Neck Surgery; the Rhinology Group, Chinese Medical Doctor Association of Otorhinolaryngology-Head and Neck Surgery; and the Nasal and Ocular Allergy Group, Chinese Society of Allergy have convened an expert panel consisting of principal investigators experienced in clinical trials of biologic treatment for CRSwNP. This expert panel was assembled to discuss the application of biologic agents in patients with CRSwNP in China. Additionally, the latest findings on the pathogenesis of CRSwNP, mechanisms of biologic agents, and efficacy and safety of biologic treatment in patients with CRSwNP were reviewed, with a special emphasis on research evidence from China. The expert panel reached a consensus on several critical issues, including criteria for the prescription, treatment course, and efficacy evaluation from a Chinese perspective. This position paper aims to guide Chinese physicians in the use of biologic agents for patients with CRSwNP. As our experience with biologic treatment continues to grow, this position paper will be further updated.

Keywords: China; biologics; chronic rhinosinusitis with nasal polyps; monoclonal antibody; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**FIGURE 1**
Pathogenesis of chronic rhinosinusitis with nasal polyps and biologics targeting key molecules mediating type 2 inflammation. EOS, eosinophil; DC, dendritic cell; B, B cell; Th, T helper cell; IL, interleukin; IgE, immunoglobulin E; IL‐4Rα, IL‐4 receptor alpha; TSLP, thymic stromal lymphopoietin. Figure were created with BioRender.com (agreement number: ZP27HEOIU0).

**FIGURE 2**
Indication for biological treatment in CRSwNP. CRSwNP, chronic rhinosinusitis with nasal polyp; NPS, nasal polyp score; NCS, nasal congestion score; HPF, high‐power field.

**FIGURE 3**
Flow chart of biologic treatment monitoring. NPS, nasal polyp score. †Decrease in NPS compared with baseline. ‡ Physicians can adjust the course based on individual patient's situation and preferences beyond 12 months.

See this image and copyright information in PMC

References

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Chinese Position Paper on Biologic Therapy for Chronic Rhinosinusitis With Nasal Polyps

Affiliations

Chinese Position Paper on Biologic Therapy for Chronic Rhinosinusitis With Nasal Polyps

Authors

Affiliations

Abstract

Conflict of interest statement

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