Abstract
Introduction: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is often associated with persistent symptoms and impaired quality of life despite treatment with intranasal corticosteroids. Biologics (dupilumab, mepolizumab, omalizumab) have been recently approved for CRSwNP. This study aims to characterize biologic use and real-world outcomes, including medication use and nasal polyps (NP) surgeries, following biologic treatment in US patients with CRSwNP. Methods: This retrospective cohort study analyzed linked data from IQVIA longitudinal prescription and medical claims databases (July 2018–June 2023). Patients evaluated included those with ≥ 2 diagnoses of CRSwNP and ≥ 12 months of baseline data (overall cohort, index = first observed CRSwNP diagnosis) as well as patients with CRSwNP who received ≥ 2 consecutive biologic doses and had ≥ 24 months of follow-up data (biologic cohort, index = first biologic). Results: Of 74,480 patients with CRSwNP, 8716 (12.0%) received a biologic and 2208 met all inclusion criteria. Dupilumab was the most frequently received biologic (89.8%; mepolizumab, 5.3%; omalizumab, 4.8%). Relative to the overall cohort, the biologic cohort was younger (mean age: 52.6 vs. 57.6 years), had more women (54.0% vs. 46.1%) and had a higher baseline prevalence of asthma (72.4% vs. 30.9%), allergic rhinitis (70.6% vs. 37.4%), NP surgery (15.8% vs. 5.8%), oral corticosteroid (OCS) use (84.0% vs. 51.8%), and antibiotic use (84.2% vs. 68.7%). During the 24 months after biologic initiation, 65.6% of patients had ≥ 1 OCS use (≥ 2 OCS uses during months 1–12, 27.0%; during months 13–24, 27.0%) and 77.9% had ≥ 1 antibiotic use; and 7.1% of patients without NP surgery before biologic initiation had ≥ 1 NP surgery during follow-up. Almost half of patients (49.3%) discontinued (≥ 90 days without receipt) their initial biologic during follow-up. Conclusion: Biologic use was relatively low among US patients with CRSwNP. OCS and antibiotic usage among patients with CRSwNP remained substantial despite use of currently approved biologics, indicating an unmet need for improved treatment options.
| Original language | English (US) |
|---|---|
| Article number | 104106 |
| Pages (from-to) | 1783-1799 |
| Number of pages | 17 |
| Journal | Advances in Therapy |
| Volume | 42 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2025 |
Funding
This study was funded by AstraZeneca Inc. AstraZeneca Inc. also provided funding for the journal\u2019s Rapid Service Fee and Open Access Fee. Anju T. Peters has received fees for sponsored research from AstraZeneca, Merck and Sanofi, and consultancy fees from AstraZeneca, Chiesi, GSK, Merck, Eli Lilly, and Sanofi. Joseph K. Han has received consultancy fees from AstraZeneca, Genentech, Gossamer Bio, GSK, Novartis, Regeneron Pharmaceuticals and Sanofi. Joseph D. Spahn, Sze-jung S. Wu, Tham T Le, and Christopher S. Ambrose are employees of AstraZeneca and may own stock or stock options in AstraZeneca. Andrew W. Lindsley is an employee of Amgen and owns stock in Amgen. Rifat Tuly, Elizabeth J. Wang, Xiaohui Zhao and Aimee M. Near are employees of IQVIA, which received funding from AstraZeneca to conduct the research study. Inyoung Lee was an employee of IQVIA during the study conduct and is currently employed by AbbVie. The authors would like to thank Kate Lovett, MPH, senior medical writer at IQVIA, for her assistance in drafting and preparation of this manuscript. Kate Lovett\u2019s work was funded by AstraZeneca Inc, in accordance with Good Publication Practice (GPP 2022) guidelines.
Keywords
- Allergist/immunologist
- Biologics
- Chronic rhinosinusitis with nasal polyposis (CRSwNP)
- Dupilumab
- Ear-nose-throat
- Mepolizumab
- Omalizumab
- Otolaryngologist
- Real-world data
ASJC Scopus subject areas
- Pharmacology (medical)
