{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T19:55:25Z","timestamp":1778097325163,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T00:00:00Z","timestamp":1737244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Type 2 inflammation dominates eosinophilic chronic rhinosinusitis (eCRS) and adult onset asthma. IL\u20104, \u20105, and \u201013 are prominent disease mediators. Disease control can be achieved with biologic therapies. However, despite some patients entering remission, others experience poor control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We aimed to describe eCRS patients treated with anti\u2010IL\u20105R antibody (benralizumab) and assess characteristics between responders and those requiring class switching to anti\u2010IL\u20104\/13R (dupilumab).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective cohort study was performed on consecutive adult patients with eCRS and asthma who had commenced benralizumab. \u00a0Disease control was defined as controlled or poorly controlled (EPOS2020 partly control\/uncontrolled). Poorly controlled patients were switched to dupilumab.\u00a0 Baseline and post\u2010IL\u20105R characteristics including age, sex, 22\u2010item Sinonasal Outcome Test (SNOT\u201022), Asthma Control Questionnaire (ACQ) score, and serum\/tissue eosinophilia were assessed. Disease control post\u2010class switching was reassessed. Factors predicting poorly controlled disease on anti\u2010IL\u20105R therapy were sought.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty patients were assessed (51.44 \u00b1 12.73 years, 56% female). Poorly controlled disease on anti\u2010IL\u20105R requiring class switch to dupilumab was seen in 42%. Poorly controlled patients were younger (46.14 \u00b1 10.76 vs. 55.28 \u00b1 12.83 years, <jats:italic>p<\/jats:italic> = 0.01) with higher baseline SNOT\u201022 (61.42 \u00b1 19.19 vs. 42.32 \u00b1 21.55, <jats:italic>p<\/jats:italic> &lt; 0.01). Baseline ACQ scores and eosinophil count (0.78 \u00b1 0.49 vs. 0.62 \u00b1 0.34\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>cells\/L, <jats:italic>p<\/jats:italic> = 0.23) and were similar between groups. In the poorly controlled patients on anti\u2010IL\u20105R therapy, eosinophilia had reduced in both serum (0.78 \u00b1 0.5 vs. 0.02 \u00b1 0.1\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>cells\/L, <jats:italic>p<\/jats:italic> &lt; 0.01) and tissue (&gt;100 cells\/HPF: 100% vs. 29%, <jats:italic>p<\/jats:italic> = 0.01). Class switching resulted in disease control for 65%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Neither eosinophilia nor its reduction predicted a non\u2010responder group to anti\u2010IL\u20105R therapy. While the eosinophil population may be a good marker for the CRS phenotype seen in nasal polyps, it is unlikely to be the cell population driving the disease process.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23534","type":"journal-article","created":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T23:26:59Z","timestamp":1737329219000},"page":"602-607","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Persistent Eosinophilic Inflammation Is Not a Feature of Type 2 CRS Patients Failing Anti\u2010IL\u20105R Therapy and Requiring Class Switching to Anti\u2010IL\u20104\/13"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7828-8305","authenticated-orcid":false,"given":"Peta\u2010Lee","family":"Sacks","sequence":"first","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian M","family":"Meerwein","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Department of Otorhinolaryngology University Hospital Zurich and University of Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Earls","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cedric","family":"Thiel","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Choy","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raewyn G","family":"Campbell","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Department of Otolaryngology, Head and Neck Surgery Royal Prince Alfred Hospital  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Sacks","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University  Sydney Australia"},{"name":"Department of Otolaryngology, Head and Neck Surgery Concord General Hospital, University of Sydney  Sydney Australia"},{"name":"Faculty of Medicine University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Kalish","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Department of Otolaryngology, Head and Neck Surgery Concord General Hospital, University of Sydney  Sydney Australia"},{"name":"Faculty of Medicine University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-8975","authenticated-orcid":false,"given":"Richard J","family":"Harvey","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University  Sydney Australia"},{"name":"Faculty of Medicine University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2021.08.030"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31881-1"},{"issue":"3","key":"e_1_2_7_4_1","first-page":"194","article-title":"EPOS\/EUFOREA Update on Indication and Evaluation of Biologics in Chronic Rhinosinusitis With Nasal Polyps 2023","volume":"61","author":"Fokkens W. 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