J Korean Med Assoc.  2023 Sep;66(9):532-536. 10.5124/jkma.2023.66.9.532.

Treatment with biological products for chronic rhinosinusitis with nasal polyp

• Han SC
• Cha H
• Kim DY

• KMID: 2545938
• DOI: http://doi.org/10.5124/jkma.2023.66.9.532

Abstract

Background
Chronic rhinosinusitis (CRS) is further classified as CRS with nasal polyp and CRS without nasal polyp. It is also divided into type 2 and none-type 2 by immunological endotype. Nowadays, novel biological products targeting type 2 inflammation are developed and used for the treatment of CRS with nasal polyp.
Current Concepts
Dupilumab, which inhibits interleukin-4 and interleukin-13, and omalizumab, which targets immunoglobulin E, were recently approved and are currently being used as the treatment regimen for patients with recurrent CRS with nasal polyp in Korea. Many studies demonstrated enough effects of both biological products on nasal symptoms, including smell, quality of life, and polyp size. The indication of biological products is refractory CRS with nasal polyp with severe symptoms even after endoscopic sinus surgery. However, the main drawback of these biological products is a high cost since they are non-reimbursement regimens as defined by Korean national health insurance.
Discussion and Conclusion
Further research on the use of dupilumab and omalizumab in Korean patients will be needed because the Korean CRS endotype, which is characterized by less-type-2 CRS, is different from Western CRS endotypes. Additionally, investigations on the comparison of efficacy among various biological products are essential to prescribe the most appropriate biological products depending on the patients’ endotypes.

Keyword

Rhinitis; Sinusitis; Nasal polyps; Biological products; 비염; 부비동염; 비용종; 생물학적제제