D3.434 - Effectiveness of Biologic Therapies in Adults With Chronic Rhinosinusitis With Nasal Polyps: Real-World Data

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease associated with impaired quality of life and a high tendency for postoperative recurrence. In patients with type 2 inflammation who are refractory to conventional therapies, biologic agents have emerged as an important treatment option in recent years. This study presents real-world clinical experience with biologic therapy in adult patients with CRSwNP undergoing biologic therapy at Ankara University.

Adult patients (≥18 years) diagnosed with CRSwNP who initiated biologic therapy and completed at least 16 weeks of treatment were included in the study. Patients who underwent surgery during follow-up or had a treatment duration shorter than 16 weeks were excluded. Nasal symptom severity was assessed using the Visual Analog Scale (VAS), and disease-specific quality of life was evaluated with the Sino-Nasal Outcome Test-22 (SNOT-22). Baseline (month 0) and 6-month follow-up measurements were compared.

A total of 20 patients with a mean age of 47.5 ± 10.8 years were included; 40% were female and 60% were male. Asthma was present in 80% of patients, and 40% had severe asthma. Non-steroidal anti-inflammatory drug–exacerbated respiratory disease (NERD) was observed in 55% of patients. The mean duration of biologic therapy was 11.6 months (range: 6–37 months). The most frequently used biologic agent was mepolizumab (75%, n=15), followed by omalizumab (15%, n=3), benralizumab (5%, n=1), and dupilumab (5%, n=1) (Table 1).

Following biologic therapy, significant improvement was observed in all VAS sub-parameters and in SNOT-22 scores (p < 0.001). The mean baseline SNOT-22 score of 60.3 ± 19.1 decreased to 25.1 ± 14.6 at 6 months (Z = −3.80, p < 0.001) (Figure 2). Compared with baseline, significant reductions were observed at month 6 in VAS scores for loss of smell (VAS-1; Z = −2.57, p = 0.010), nasal discharge (VAS-2; Z = −3.83, p < 0.001), nasal obstruction (VAS-3; Z = −3.87, p < 0.001), facial pressure (VAS-4; Z = −3.35, p < 0.001), headache (VAS-5; Z = −3.18, p = 0.001), nasal itching (VAS-6; Z = −3.73, p < 0.001), and sneezing (VAS-7; Z = −3.44, p < 0.001) (Figure 1).

In the subgroup analysis of patients receiving mepolizumab alone (n = 15), significant improvement was similarly observed across all VAS sub-parameters (Z values ranging from −1.97 to −3.33; all p < 0.05).

Real-world data demonstrate that biologic therapies provide significant improvement in both symptom severity and quality of life in patients with CRSwNP. Mepolizumab, the most commonly used agent in this cohort, significantly reduced all symptom scores. These findings support the effectiveness and safety of biologic therapies, particularly in patients with CRSwNP who are refractory to surgical treatment.