Biologics for chronic rhinosinusitis with nasal polyps: a real-world prospective cohort study
(2026) Rhinology Journal — Vol. 64, n° 4, p. 0 (2026)
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- Background: Monoclonal antibody therapies targeting type 2 inflammation for chronic rhinosinusitis with nasal polyps (CRSwNP) have shown efficacy in randomized controlled trials (RCTs), however prospective real-world comparative data across all appro ved biologics remain limited. We aimed to evaluate the real-world effectiveness of omalizumab, mepolizumab, and dupilumab in patients with severe CRSwNP. Methodology: A prospective, multicentre, real-world phase IV study in Belgium, enrolling 360 patients with severe CRSwNP initiating treatment with omalizumab (n=65), mepolizumab (n=242), or dupilumab (n=53) between March 2022 and April 2025. Clinical data were collected at baseline and after 6 months. The therapeutic response was evaluated based on EUFOREA criteria. Results: After 6 months, nasal polyp score (NPS), olfactory function, and patient-reported outcomes improved across all biologics, with concurrent improvements in asthma control within each treatment group. A good-to-excellent multidomain therapeutic response was achieved in 51% of patients, and treatment continuation beyond 6 months was observed in 74% of omalizumab-, 81% of mepolizumab-, and 92% of dupilumab-treated patients. No severe adverse events were reported. Conclusion: In this real-world cohort, the three registered biologics provided significant clinical benefit in severe CRSwNP, with numerically larger improvements observed in patients treated with dupilumab.
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Blauwblomme, M., Viskens, A.-S., Bonne, E., Borgers, E., Cox, C., De Vos, G., Derycke, L., Eeckels, A.-S., Halewyck, S., Hox, V., Janssen, P., Janssen, P., Lemmens, W., Rogister, F., Speleman, K., Syssauw, M., Vanderveken, O., Vandewalle, E., Vanhee, S., et al. (2026). Biologics for chronic rhinosinusitis with nasal polyps: a real-world prospective cohort study. Rhinology Journal, 64(4), 0. https://doi.org/10.4193/rhin26.004 (Original work published 2026)