Efficacy of biologic agents in patients with comorbid asthma and chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis of randomised controlled trials
Abstract
Graphial abstract Type 2 biologics in patients with asthma and comorbid chronic rhinosinusitis with nasal polyps (CRSwNP) improved asthma and sino-nasal outcomes with an acceptable safety profile. ACQ: asthma control questionnaire; AQLQ: asthma quality of life questionnaire; FEV1: forced expiratory volume in 1 s; LMK-CT: Lund–Mackay computed tomography; MD: mean difference; NC: nasal congestion/obstruction; NPS: nasal polyp score; RCT: randomised controlled trial; SNOT-22: sino-nasal outcome test 22. Background Multiple biologics targeting type 2 inflammation have been evaluated for the treatment of severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) separately. Objective To evaluate the efficacy and safety of biologics in patients with comorbid asthma and CRSwNP. Methods A systematic review of randomised controlled trials (RCTs) from Medline, Embase, Web of Science and Scopus (up to 31 October 2025) was conducted. Random-effects meta-analysis assessed efficacy and safety outcomes. Results 16 studies involving 3598 patients were included in the meta-analysis. Overall, biologics reduced asthma exacerbations by 73% (rate ratio 0.27, 95% CI 0.21–0.34), increased forced expiratory volume in 1 s by 0.21 L (95% CI 0.11–0.30), improved asthma control questionnaire score by −0.70 points (95% CI −0.83–−0.56) and asthma quality of life questionnaire score by 0.71 points (95% CI 0.49–0.93). Regarding sino-nasal outcomes, the sino-nasal outcome test 22 (SNOT-22) score…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,598 participants or records.
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