Rhinology
June 23, 2026 · via Europe PMC
Therapeutic outcomes of biologic switching in chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis.
Aljubran HJ, Alabdulaal MR, Aldhaif LA, Motabagani DM, Alhussain RM, AlWusaybie ZS, Aldhafeeri FO, Almomen A.
AI summary — for doctors, generated from the abstract only
Switching biologics in refractory CRSwNP was associated with substantial symptom improvement and an average success rate of about 79%.
What was studied
A systematic review (8 studies, 470 patients) and meta-analysis (4 studies) of biologic switching in CRSwNP.
Key findings
- Most common reason for switching was insufficient symptom control (59.7%), then side effects (10.8%)
- Mean SNOT-22 improvement of 71.4% after switching
- Switching to dupilumab significantly improved SNOT-22 and polyp scores
- Success rates ranged from 59.6% to 100% (average 79.2%)
Clinical relevance
Suggests switching is a reasonable consideration for non-responders, though evidence comes from few, likely observational studies.
Who should care
Limitations
Few included studies, with only four in the meta-analysis.
Biologic switching can help CRSwNP patients who don't respond to their first biologic.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Biological therapy is a newer line of treatment that has been utilized in practice for patients with chronic rhinosinusitis with nasal polyps, showing excellent results. However, some patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) do not respond to this therapy. Hence, this study aims to evaluate the efficacy and safety of biological switching in these patients.
Methodology
Using the Web of Science, Cochrane, MEDLINE, and Embase databases, we analyzed studies involving biological switching in CRSwNP patients published up to June 2025. The studies were extracted, and data were pooled for meta-analysis.
Results
Of 3,367 studies identified, eight studies (involving 470 patients) were included in the systematic review, four of which were included in the meta-analysis. The results showed that the most common reason for switching was insufficient CRS symptom control (59.7%), followed by undesirable side effects (10.8%). The findings demonstrated dramatic effects of biological switching in terms of the SNOT-22 score, with a mean improvement of 71.4%. In addition, studies that switched patients to dupilumab showed significant improvement after switching in both SNOT-22 and nasal polyp scores. Overall, the success rate of biological switching ranged from 59.6% to 100%, with an average success rate of 79.2%.
Conclusions
This review demonstrated the effect of biological switching as an option for patients with refractory CRSwNP or those experiencing biological side effects. These findings highlight a new therapeutic alternative that can serve as a fundamental choice when managing CRSwNP patients.
DOI
10.4193/rhin25.623
PMID
42334381
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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