Biologics in Chronic Rhinosinusitis with Nasal Polyps: The Otolaryngologist's Perspective.
Monoclonal antibodies ("biologics") have increasingly been used to manage chronic sinusitis with nasal polyps (CRSwNP). The aim of this manuscript was to compare biologic outcomes to traditional management of CRSwNP with endoscopic sinus surgery (ESS).
There are now four approved biologics for the treatment of CRSwNP in the United States: dupilumab, mepolizumab, omalizumab, and tezepelumab. Cost analysis and comparison between phase 3 clinical trial results of biologics and ESS show ESS is at least as effective as biologics in controlling symptoms with significantly less cost to the healthcare system. Recent guidelines published by the European Position paper on Rhinosinusitis and Nasal Polyps (EPOS) and the American Academy of Otolaryngology continue to support ESS in the management of CRSwNP when traditional medical therapy has failed. Biologics may be considered an option for severe uncontrolled CRSwNP that has failed comprehensive ESS. Future studies are needed to assess long-term efficacy and cost of biologics compared to ESS in CRSwNP.
There are now four approved biologics for the treatment of CRSwNP in the United States: dupilumab, mepolizumab, omalizumab, and tezepelumab. Cost analysis and comparison between phase 3 clinical trial results of biologics and ESS show ESS is at least as effective as biologics in controlling symptoms with significantly less cost to the healthcare system. Recent guidelines published by the European Position paper on Rhinosinusitis and Nasal Polyps (EPOS) and the American Academy of Otolaryngology continue to support ESS in the management of CRSwNP when traditional medical therapy has failed. Biologics may be considered an option for severe uncontrolled CRSwNP that has failed comprehensive ESS. Future studies are needed to assess long-term efficacy and cost of biologics compared to ESS in CRSwNP.