[Biologicals in Type-2-Inflammation - from Chronic Rhinosinusitis with Nasal Polyps to Hypereosinophilic Syndrome]

In recent years, several biologics have been introduced into hospitals and clinics as alternatives to surgery and/or topical/oral cortisone therapy in patients with severe refractory chronic rhinosinusitis with polyps (CRSwNP). Advances in understanding the pathophysiology of CRSwNP in relation to the predominant type 2 endotype have also paved the way for understanding possible overlaps with hypereosinophilic syndrome (HES) and eosinophilic granulomatosis with polyangiitis (EGPA). In this article, we present the biologic treatment options currently approved in Germany for the treatment of severe CRSwNP - dupilumab, omalizumab and mepolizumab - together with guidance on practical management including side effects for the indication of CRSwNP. Tips on how to select the preferred agent for an individual patient to ensure safe, effective and cost-efficient treatment will be presented and awareness of HES and EGPA will be raised.