Antibody-based therapeutics for chronic rhinosinusitis with nasal polyps

ABSTRACT

Introduction

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory condition with heterogenous underlying endotypes, the most common being type 2 mediated inflammation. Several biologics have been developed to target specific pro-inflammatory cytokines and their receptors with proven efficacy in both quantitative and qualitative outcomes in patients with severe uncontrolled disease. However, there is an ongoing debate on the role of biologics relative to conventional therapies for CRSwNP and their efficacy in patient subgroups with non-polyp type 2 disease.

Areas covered

This review examines the evidence on the efficacy and safety of biologics in CRSwNP, recommendations for their use, and discusses the broader economic factors influencing their application in clinical practice.

Expert opinion

Emerging real-life data demonstrating the variable efficacy of the available biologics for patients with CRSwNP, coupled with the high cost compared to conventional therapies such as surgery, renders biologics to be considered as an add-on therapy in the majority of cases. However, ongoing research into increasing biologic dose intervals and novel therapies targeting alternative pathways may offer a more cost-effective and sustainable option in future.

KEYWORDS:

• Biologic therapy
• chronic rhinosinusitis with nasal polyps
• antibody-based therapeutics
• monoclonal antibodies
• nasal polyposis

Article highlights

• Antibody-based therapeutics are effective for chronic rhinosinusitis and nasal polyps, targeting specific pro-inflammatory cytokines and receptors.

• Proven efficacy in both quantitative and qualitative outcomes observed in patients with severe uncontrolled disease.

• Ongoing debate about the role of biologics versus conventional therapies for CRSwNP, and their efficacy in subgroups with non-polyp type 2 disease.

• Current trials are comparing the efficacy of different biologics directly.

• Ongoing research explores the potential for extending biologic dose intervals and developing novel, cost-effective therapies targeting alternative pathways

Declaration of interest

C Hopkins has participated in Advisory Boards for Sanofi. Astra Zeneca, Lilly and GSK. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.