Related Experiment Video
Updated: May 13, 2025
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
How does asthma coexistence affect the strategic selection of biologic therapies in CRSwNP management?
Imran Ozdemir1, Nuray Bayar Muluk2, Mustafa Yazır3
1Department of Pulmonology, Medical Faculty, Üsküdar University, Istanbul, Türkiye.
Insights
Biologic therapies like dupilumab, omalizumab, and mepolizumab are effective for managing chronic rhinosinusitis with nasal polyps (CRSwNP) when asthma coexists. These treatments target specific inflammatory pathways, improving outcomes for patients with both conditions.
Area of Science:
- Immunology
- Pulmonology
- Otolaryngology
Background:
- Chronic rhinosinusitis with nasal polyps (CRSwNP) frequently co-occurs with asthma and AERD asthma, sharing common pathogenic mechanisms.
- Inflammatory pathways in CRSwNP and asthma can be heterogeneous, involving Type 2 or non-Type 2 inflammation.
- Coexisting asthma exacerbates lower airway inflammation and reduces asthma control in CRSwNP patients.
Purpose of the Study:
- To review the coexistence of asthma and the selection of biologic therapies for CRSwNP management.
- To explore the role of targeted biologic medications in treating CRSwNP with comorbid asthma.
Main Methods:
- A comprehensive literature review was conducted using PubMed, EBSCO, Proquest Central, Google, and Google Scholar.
- Searched terms included "CRSwNP", "asthma", "biologic therapies", "Dupilumab", "Omalizumab", and "mepolizumab" from 2000 to 2024.
Main Results:
- Patients with CRSwNP often have coexisting lower airway diseases, notably asthma.
- Biologic agents such as dupilumab, omalizumab, and mepolizumab are FDA-approved for CRSwNP treatment.
- European guidelines provide clear indications for biologic therapy in CRSwNP, with concomitant asthma being a key criterion.
Conclusions:
- Biologic treatments offer a promising therapeutic option for patients with coexisting CRSwNP and asthma.
- Omalizumab, dupilumab, and mepolizumab are recommended biologic treatments for this patient population.
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.
More Related Videos
06:08Author Spotlight: Advancing Allergic Rhinitis Research with Multicolor Immunofluorescence
Published on: September 22, 2023
06:34A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma
Published on: June 4, 2017
Related Concept Videos
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:17Drugs Used in Lower Respiratory Disorders: Overview
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.