Real-world effectiveness of T2-biologics in severe allergic asthma with nasal polyps

In this video, Prof Dr Angelica Tiotiu presents a real-world multicentre study comparing three classes of type 2 biologics in patients with severe allergic asthma and nasal polyps: anti-IgE, anti-IL-5/IL-5 receptor and anti-IL-4 receptor therapies.

The analysis included 107 biologic-naive patients treated for at least 6 months: 35 received anti-IgE therapy, 38 anti-IL-5/IL-5 receptor therapy and 34 anti-IL-4 receptor therapy. Outcomes assessed before and after treatment included asthma symptoms and control, exacerbations, rescue medication use, lung function, sinonasal symptoms, nasal polyp scores, sinus imaging and blood eosinophil counts.

All three biologic classes produced comparable improvements in asthma control, exacerbation rates and lung function, while also improving most sinonasal outcomes. Anti-IL-4 receptor therapy was associated with greater improvements in loss of smell, nasal obstruction and endoscopic nasal polyp score. Anti-IgE therapy appeared particularly beneficial for allergic nasal symptoms, whereas anti-IL-5/IL-5 receptor treatment achieved the greatest reductions in blood eosinophil counts.

These findings suggest that all three approaches are effective, although the pattern of benefit may help guide treatment selection according to the patient’s predominant clinical features.