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Biologic Therapies for Allergic Rhinitis and Nasal Polyposis

  • Rhinitis, Conjunctivitis, and Sinusitis (J Oppenheimer and J Corren, Section Editors)
  • Published:
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Abstract

Purpose of Review

There is an emerging body of research on targeted biologic therapies for the treatment of severe inflammatory nasal disorders, especially chronic rhinosinusitis with nasal polyposis (CRSwNP). This paper will evaluate the efficacy of biologic therapies for severe nasal inflammation by summarizing key preclinical trials of biologics for animal models of allergic rhinitis and the recent phase 2 and 3 clinical trials of biologic therapies for CRSwNP.

Recent Findings

Biologics that target the IL-4 receptor (dupilumab), IgE (omalizumab), and IL-5 (mepolizumab, reslizumab, and benralizumab) in patients with CRSwNP have shown improvement of various metrics including Sino-Nasal Outcome Test (SNOT-22) scores, Nasal Polyp Scores (NPS), Nasal Congestion Scores (NCS), and Lund-Mackay sinus opacification scores.

Summary

The efficacy demonstrated through the dupilumab phase 3 trials (LIBERTY NP SINUS-24 and SINUS-52) led to approval of the first biologic for the treatment of CRSwNP. Phase 3 trials for omalizumab (POLYP 1 and 2) and mepolizumab (SYNAPSE study) and post hoc analyses of phase 3 asthma studies for reslizumab and benralizumab have also demonstrated positive results for the use of biologics for patients with CRSwNP. Future efficacy studies and risk/benefit and cost analyses of these biologics and other cytokine targets for allergic rhinitis with and without nasal polyposis need to be performed.

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Authors and Affiliations

  1. University of California San Diego and Rady Children’s Hospital, San Diego, CA, USA

    Bob Geng & Michelle Dilley

  2. University of Washington School of Medicine, Seattle, WA, USA

    Christine Anterasian

Authors
  1. Bob Geng
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  2. Michelle Dilley
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  3. Christine Anterasian
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Correspondence to Bob Geng.

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Conflict of Interest

Author BG has the following disclosures relevant to this manuscript: speaking honoraria from GSK, Sanofi, Regeneron, and OptiNose as well as consulting fees from Regeneron and Astra-Zeneca; Research Support from Genentech.

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This article is part of the Topical Collection on Rhinitis, Conjunctivitis, and Sinusitis

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Geng, B., Dilley, M. & Anterasian, C. Biologic Therapies for Allergic Rhinitis and Nasal Polyposis. Curr Allergy Asthma Rep 21, 36 (2021). https://doi.org/10.1007/s11882-021-01013-y

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