How does asthma coexistence affect the strategic selection of biologic therapies in CRSwNP management?

Objectives: We reviewed asthma coexistence and the selection of biologic therapies in CRSwNP Management.

Methods: The literature review utilized Google and Google Scholar, in addition to PubMed, EBSCO, and Proquest Central at Kırıkkale University. We searched for " CRSwNP", "asthma", "biologic therapies", "Anti-IL-4RA", "Dupilumab", "Anti-IgE", "Omalizumab", "Anti-IL-5", "mepolizumab" from 2024 to 2000.

Results: Patients with CRSwNP frequently have co-occurring lower airway illnesses, including asthma and AERD asthma, which have a shared pathogenesis. The inflammatory bases of CRSwNP and asthma might be heterogeneous, with a type 2 or, less frequently, a non-type two inflammatory history. Lower airway inflammation and asthma control are worse in patients with asthma who also have CRSwNP. Patients with CRSwNP can now access targeted biologic medicines, a novel therapy option. The US Food and Drug Administration (FDA) has authorized three medications for CRSwNP: dupilumab, omalizumab, and mepolizumab. To treat chronic rhinosinusitis with a biological agent, the 2020 European position paper on rhinosinusitis established clear indications. A patient is considered a biologic therapy candidate if they have either undergone FESS before or did not meet FESS criteria but met three of the five. A diagnosis of concomitant asthma, necessitating an inhaled glucocorticoid controller regularly, is one of the five requirements.

Conclusion: Biologic treatments have the potential to be used in certain patients where CRSwNP and asthma coexist. The recommended treatments include omalizumab, dupilumab, and mepolizumab.