Advance in biologics for chronic rhinosinusitis with nasal polyps

Managing chronic rhinosinusitis with nasal polyps (CRSwNP) poses challenges, especially when conventional treatments fail to achieve adequate symptom control. CRSwNP is often marked by type 2 inflammation, and a large number of patients have other comorbid type 2 conditions, such as asthma. Currently, 4 biologics have been approved to treat CRSwNP-dupilumab, omalizumab, mepolizumab, and stapokibart (stapokibart is approved in China but not by the US Food and Drug Administration)-with additional promising therapies currently under development. Biologics can enhance the quality of life for CRSwNP patients, reduce the need for systemic corticosteroid therapy and endoscopic sinus surgery (ESS), and improve the management of comorbid conditions. We review clinical trials and real-world data on the effectiveness and safety of biologics for CRSwNP, compare biologic therapy and ESS, and explore the switching and simultaneous use of biologics.