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

Figures & data

Table 1 Table Describing Biologics Discussed Including: Name, Target, FDA Approvals, Mechanism, Dosing and Side Effects

Generic Name	Trade Name	Target	FDA Approvals	Dosing	Side Effects
Omalizumab	Xolair	Anti-IgE via Fc receptor blockade	CRSwNP; Allergic Asthma; Chronic Uticaria	Subcutaneous injection every 2–4 weeks	● Sinusitis ● Headache ● Pharyngitis ● Injection site reaction ● 0.2% risk of anaphylaxis
Mepolizumab	Nucala	Anti-IL5	Eosinophilic Asthma	Monthly subcutaneous injections	● Headache ● Fatigue ● Injection site reaction
Benralizumab	Fasenra	Anti-IL5 via IL5-R alpha receptor blockade		Monthly subcutaneous injections for 3 months then every other month	● Headache ● Pharyngitis ● Injection site reaction
Dupilumab	Dupixent	Anti-IL4 and IL-13 via IL-4Ra receptor blockade	CRSwNP; Atopic Dermatitis	Subcutaneous injection every other week	● Nasopharyngitis ● Headache ● Injection site reaction

Figure 1 Algorithm proposed by authors for use of biologics in the management of chronic rhinosinusitis with nasal polyps.

Abbreviations: ESS, endoscopic sinus surgery; AERD, aspirin exacerbated respiratory disease; AFS, allergic fungal sinusitis.