Biologic Therapy in Pediatric Chronic Rhinosinusitis: A Systematic Review

Area of Science:

• Pediatric Otolaryngology
• Immunology
• Pharmacology

Background:

• Chronic rhinosinusitis with nasal polyposis (CRSwNP) significantly impacts children's quality of life.
• Biologic therapies have shown efficacy in adult CRSwNP and pediatric conditions like asthma and atopic dermatitis.
• Evidence for biologic use in pediatric CRSwNP is currently limited.

Purpose of the Study:

• To review the current evidence for biologic therapy in children diagnosed with CRSwNP.
• To identify existing research and clinical trials investigating biologics for pediatric CRSwNP.
• To assess the potential role of biologics in managing pediatric CRSwNP.

Main Methods:

• A comprehensive literature search was conducted using PubMed, MEDLINE, Cochrane, and clinical trial registries.
• Key search terms related to biologic therapy and pediatric CRSwNP were utilized.
• The review focused on identifying studies and trials specifically addressing biologics in this population.

Main Results:

• A significant lack of active clinical trials and research studies for biologics targeting pediatric CRSwNP was identified.
• One ongoing compassionate-use trial for Dupilumab in children with nasal polyps was noted.
• Only one published study specifically examined Dupilumab for pediatric CRSwNP in the context of aspirin-exacerbated respiratory disease.

Conclusions:

• Current evidence for biologic therapy in pediatric CRSwNP is scarce.
• Biologics show promise for managing the unified airway in children with CRSwNP.
• Further Phase III clinical trials are essential to expand indications for biologics in pediatric CRSwNP, especially for those with comorbidities.