Biologics for people with chronic rhinosinusitis | Figure 1

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Biologics for people with chronic rhinosinusitis

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What is the aim of this review?

'Biologics' is the name given to a new type of drug. This type is increasingly being used to help people with diseases due to inflammation of body tissues. The aim of this review is to see if any of these drugs are effective in treating people with 'chronic rhinosinusitis'. These patients have long‐term problems with inflammation of the nose and sinuses. This leads to them having blocked, stuffy, runny noses and pain in their cheeks. They often need to use long‐term steroid nasal sprays. Some patients with chronic rhinosinusitis also get polyps in their nose. These can make their symptoms worse.

Key message

One of the new biologics – called dupilumab – helps people with severe chronic rhinosinusitis who also have nasal polyps. It makes their symptoms better and shrinks their polyps. It does not seem to cause any severe side effects. Another similar drug – called mepolizumab – may do the same but we are less certain about that.

What was studied in the review?

We looked for trials where patients with chronic rhinosinusitis had been given either one of the new biologic drugs or a placebo (dummy) treatment. They needed to have been treated for at least three months. We looked for studies that measured the effect of the drug on people's symptoms and their general health.

What are the main results of the review?

Almost all the people studied in the trials had severe chronic rhinosinusitis with nasal polyps (so we can only draw conclusions about the effects of the drugs on people like this). We found eight studies, looking at three different drugs. Most of the information we have comes from two big trials (with nearly 800 patients) looking at the effect of one drug – dupilumab.

Effect of dupilumab

After 24 weeks of treatment, people taking dupilumab have a better quality of life than those who do not and their polyps have shrunk more. On average their symptoms are probably better too, and they do not have more severe side effects than those taking placebo.

Effect of mepolizumab

The effect of mepolizumab was studied in far fewer patients and so we are less certain about the results. We can say that this drug may have similar effects to dupilumab.

Effect of omalizumab

We found very little information about the use of this drug and cannot say whether it is effective or not.

How up‐to‐date is this review?

The evidence is up‐to‐date to September 2019.

Read the full Cochrane Review here

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