Objective: Nasal polyps (NP) are chronic inflammatory lesions commonly associated with asthma and non-steroidal anti-inflammatory drug exacerbated respiratory disease (N-ERD). This study aimed to evaluate the clinical characteristics and real-world outcomes of biologic therapy in patients with NP and asthma, with particular focus on biologic agent subgroups and clinically defined N-ERD status.
Materials and Methods: In this single-center, retrospective, small cohort study conducted between May 2024 and August 2025, we reviewed patients with asthma and NP who received biologic therapy for at least six months in our Department of Allergy and Clinical Immunology. Patients were stratified according to the presence or absence of N-ERD. Demographic characteristics, laboratory findings, and clinical outcomes, including Asthma Control Test (ACT) and Sinonasal Outcome Test (SNOT‑22) scores, were collected at baseline and after six months of treatment.
Results: A total of 28 patients with NP and asthma were included in the study. Of these, 22 patients were initiated on biologic therapy for severe asthma (SA), while 6 patients with mild persistent asthma received off-label biologic treatment for NP. Overall, 15 patients (53.6%) were classified as having clinically defined N-ERD. Eleven patients were treated with mepolizumab, 10 with benralizumab, and 7 with omalizumab. Biologic therapy was associated with significant improvements in patient-reported sinonasal symptoms, as reflected by reductions in SNOT-22 scores, when analyzed separately for each biologic agent. Significant clinical improvements were observed in both the N-ERD-positive and N-ERD-negative groups, including reductions in SNOT-22 scores and increases in ACT scores and FEV₁ values (p<0.05 for all outcomes).
Conclusion: With appropriate patient selection, biologic therapies were associated with improvements in both patient-reported sinonasal symptoms and asthma-related outcomes in patients with NP and concomitant asthma, irrespective of clinically defined N-ERD status. These findings support the potential real-world utility of type 2-targeted biologics in patients with NP and concomitant asthma.