Three biologic classes beneficial for severe allergic asthma with nasal polyps in real world

All biologic classes—anti-IgE, anti-IL5/R, and anti-IL4R—help improve outcomes in patients with severe allergic asthma with nasal polyps (SAA-NP) treated in real-world settings, according to a study. However, anti-IL4R bests the other two in terms of improving the smell, nasal obstruction, and nasal polyp endoscopic size.

The real-world, multicentre study included 107 patients with SAA-NP who were treated with anti-IgE, anti-IL5/R, or anti-IL4R for 6 months. Researchers looked at the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging, and the blood eosinophil count at 6 months before and after treatment.

Of the patients, 35 were in the anti-IgE group, 38 in the anti-IL5/R group, and 34 in the anti-IL4R group. Results showed that asthma outcomes (symptoms, exacerbation rate, asthma control, lung function) improved similarly across all treatment groups at 6 months post-treatment.

While all rhinological parameters and sinus imaging results became better in each group after treatment, greater benefits were seen in the anti-IL4R group with respect to loss of smell (odds ratio [OR], 3.64, 95 percent confidence interval [CI], 1.3–11.1; p=0.017), nasal obstruction (OR, 12.00, 95 percent CI, 2.00–23.10; p=0.023), and nasal polyp endoscopic score (OR, 18.10, 95 percent CI, 4.43–24.50).

Additional comparative studies with larger populations are needed to validate the results.