Tănase Mihai I, Tanase Mara, Cosgarea Marcel, Radeanu Gheorghe Doinel, Pop Septimiu Sever, Maniu Alma A
Department of Otolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, ROU.
Cureus. 2025 Jan 22;17(1):e77804. doi: 10.7759/cureus.77804. eCollection 2025 Jan.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition of the nasal passages and sinuses, often characterized by nasal congestion, loss of smell, facial pressure, and nasal discharge. Conventional treatments, such as corticosteroids and endoscopic sinus surgery (ESS), often provide only temporary relief, with frequent recurrence of symptoms. For patients with severe, refractory CRSwNP, biologic therapies have emerged as a promising treatment option. This review evaluates the efficacy and safety of biologic treatments for CRSwNP, including dupilumab, mepolizumab, and omalizumab. We analyze clinical trial data, patient-reported outcomes, and the latest research on the use of biologics in CRSwNP management. Our findings confirm the efficacy of biologics in treating CRSwNP, showing consistent improvements in both clinical and patient-reported outcomes. The use of biologics resulted in a significant reduction in nasal polyp size, improved nasal congestion, and reduced the need for further surgery or systemic corticosteroids. Moreover, patients experienced an improved sense of smell and a better quality of life. This review also includes a comparative analysis of the three biologics, highlighting their efficiency and potential risks. The findings suggest that dupilumab may be the most effective biologic therapy for CRSwNP, showing superior efficacy compared to mepolizumab and omalizumab in reducing nasal polyp size and improving nasal congestion. The article provides valuable insights for healthcare providers and patients considering biologic therapy for CRSwNP, emphasizing the importance of personalized treatment decisions based on individual patient factors, including disease severity, comorbidities, and preferences.
伴鼻息肉的慢性鼻-鼻窦炎(CRSwNP)是鼻腔和鼻窦的一种慢性炎症性疾病,通常表现为鼻塞、嗅觉减退、面部压迫感和鼻腔分泌物增多。传统治疗方法,如皮质类固醇和鼻内镜鼻窦手术(ESS),往往只能提供暂时缓解,症状频繁复发。对于重度、难治性CRSwNP患者,生物疗法已成为一种有前景的治疗选择。本综述评估了生物制剂治疗CRSwNP的疗效和安全性,包括度普利尤单抗、美泊利单抗和奥马珠单抗。我们分析了临床试验数据、患者报告的结果以及生物制剂在CRSwNP治疗中应用的最新研究。我们的研究结果证实了生物制剂在治疗CRSwNP方面的疗效,在临床和患者报告的结果方面均显示出持续改善。使用生物制剂可显著缩小鼻息肉大小,改善鼻塞,并减少进一步手术或全身使用皮质类固醇的需求。此外,患者的嗅觉和生活质量也有所改善。本综述还对这三种生物制剂进行了比较分析,突出了它们的疗效和潜在风险。研究结果表明,度普利尤单抗可能是治疗CRSwNP最有效的生物疗法,在缩小鼻息肉大小和改善鼻塞方面比美泊利单抗和奥马珠单抗显示出更高的疗效。本文为考虑对CRSwNP采用生物疗法的医疗服务提供者和患者提供了有价值的见解,强调了基于个体患者因素(包括疾病严重程度、合并症和偏好)做出个性化治疗决策的重要性。