Related Experiment Video
Updated: Aug 16, 2026
06:13
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Outcomes of Biologic Switching in Chronic Rhinosinusitis With Nasal Polyps
Beverly J Fu1, Itzel Jimenez1, Michael T Chang1
1Division of Rhinology and Skull Base Surgery, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
American Journal of Rhinology & Allergy
|August 14, 2026
Summary
Many patients with chronic rhinosinusitis with nasal polyps (CRSwNP) switch biologics due to inadequate response. Switching to another biologic, often dupilumab, is effective for refractory CRSwNP, yielding outcomes similar to initial responders.
Area of Science:
- Immunology and Respiratory Medicine
- Clinical Therapeutics
Background:
- Biologic therapies offer new treatment avenues for chronic rhinosinusitis with nasal polyps (CRSwNP).
- A significant proportion of CRSwNP patients exhibit inadequate response to initial biologic treatments, necessitating therapy switches.
- Outcomes, especially patient-reported measures, following biologic switches in CRSwNP are not well-documented.
Purpose of the Study:
- To identify predictors of biologic switching in adult CRSwNP patients.
- To characterize the outcomes of biologic switching in adult CRSwNP patients.
- To evaluate the effectiveness of switching biologics for refractory CRSwNP.
Main Methods:
- Retrospective review of adult CRSwNP patients initiating biologics between 2009 and 2025.
- Collection of demographic, clinical, radiographic, histopathologic, and Sinonasal Outcome Test-22 (SNOT-22) data.
- Analysis of predictors and outcomes associated with biologic switching.
Main Results:
- 18% of 400 patients switched biologics; switching was more common with omalizumab and mepolizumab than dupilumab.
- Patients switching biologics often had comorbidities like asthma, aspirin-exacerbated respiratory disease, and COPD.
- Following a switch, 70.6% of patients improved, with a mean SNOT-22 score reduction of 9.4 points, achieving outcomes comparable to non-switchers.
Conclusions:
- Biologic switching in CRSwNP is frequently driven by inadequate symptom control, with dupilumab being a common subsequent therapy.
- Switching biologics is an effective strategy for managing refractory CRSwNP.
- Outcomes after biologic switching can be comparable to initial responders, even in patients with greater baseline disease severity.
Related Concept Videos
01:30Epistaxis
Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
01:29Suctioning the Nasopharyngeal Airway
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required