Simultaneous Dual Type 2 Biologic Therapy Improves Sinonasal Outcomes in Selected Patients With Chronic Rhinosinusitis With Nasal Polyps.
Dual biologic therapy tied to large improvement in sinonasal symptom scores in nasal polyps
Simultaneous Dual Type 2 Biologic Therapy Improves Sinonasal Outcomes in Selected Patients With Chronic Rhinosinusitis With Nasal Polyps.
Due to the shared underlying pathophysiological mechanism, chronic rhinosinusitis with nasal polyps (chronic rhinosinusitis with nasal polyps) is frequently associated with comorbid systemic type 2 diseases.
The aim of this study was to assess current use of dual biologic therapy in patients with chronic rhinosinusitis with nasal polyps.
This retrospective, multicentric study included adult patients with a diagnosis of severe uncontrolled chronic rhinosinusitis with nasal polyps and simultaneous dual type-2 biologic therapy, one of which had to be approved for the treatment of chronic rhinosinusitis with nasal polyps.
Most patients showed complex medical histories with type 2 comorbidities and several futile treatment attempts.
Most frequent comorbidities were asthma (n = 32), eosinophilic granulomatous polyangiitis (n = 13), and hypereosinophilic syndrome (n = 5).
Cessation of dual therapy was attempted in four patients, but reintroduced again due to loss of disease control.
Five adverse reactions were reported in 4 (11.8%) patients: urticaria, erythema, gastrointestinal symptoms, weight gain, and arthralgia (each n = 1).
In rare cases, dual biologic therapy can be indicated to control chronic rhinosinusitis with nasal polyps and comorbid type 2 diseases.
The long-term efficacy and safety of this approach remain unknown and should be reserved for carefully selected cases only, considering the off-label use in some European countries and high associated costs.