A comparison between efficacy and adverse effects of three approved respiratory biologics

BiologicsEfficacyAdverse effects
Dupilumab

Reduces:

  • Postnasal drip

  • Rhinorrhea

  • Nasal congestion

  • Endoscopic and radiologic sinus inflammation

  • Need for oral glucocorticoids

  • Need for FESS

Improves:

  • Sense of smell [57, 58]

  • Injection site reactions

  • Peripheral eosinophilia

  • Insomnia

  • Toothache

  • Gastritis

  • Arthralgia

  • Noninfectious conjunctivitis [60]

  • T helper driven diseases (seronegative arthritis, psoriasis enthesitis, and iridocyclitis) [61, 62]

Omalizumab

Improves:

  • Smell tests

  • Quality of life measures

  • NP burden

  • Post nasal drip

  • Rhinorrhea [63]

  • Skin inflammation

  • Anaphylaxis [64]

Mepolizumab

Improves:

  • NP size

  • Nasal obstruction [65]

  • No significant adverse effect [65]

FESS: functional endoscopic sinus surgery; NP: nasal polyposis