D2.108 - Type 2 Inflammation Biomarkers in Patients with Chronic Rhinosinusitis with Nasal Polyps Under Treatment with Biologic Agents

Chronic rhinosinusitis with nasal polyps is a clinical entity characterized by the presence of type-2 inflammatory markers. Nowadays, biological therapies are available that target this condition or its most common comorbidity, asthma. The purpose of this review is to document and analyze the profile of patients with chronic rhinosinusitis with nasal polyps who receive treatment with biological agents.

We conducted a review of the medical records of patients with chronic rhinosinusitis with nasal polyps who were receiving biological agents (omalizumab, mepolizumab, dupilumab, benralizumab, tezepelumab) and were being followed in our department.

A total of 20 patients were included, with a median age of 57 years, of whom 10 were male. The median age at symptom onset was 36.5 years, with 18 patients (85%) also having asthma, 1 in 3 presenting with Samter’s triad, and one patient diagnosed with EGPA. The median peripheral eosinophil count was 645 (90–2500) cells/μL, with the vast majority (19/20) having >300, while the median total IgE level was 168 IU/mL (29–2240), with most (15/20) having >100. Half of the patients were sensitized to common aeroallergens: 6 to Olea, 6 to Parietaria, 6 to grasses, and 5 to house dust mites. Sensitization to staphylococcal enterotoxins A and/or B (SEA and/or SEB) was identified in 5 patients—3 to SEA, 4 to SEB, and 2 to both—with all of them having eosinophils >300 and total IgE >100. More than one biological agent had been administered in 10 of the 20 patients.

The presence of type-2 inflammatory markers confirms the findings of the international literature, and these markers appear to be elevated when sensitization to staphylococcal allergens is also present.