{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:29:09Z","timestamp":1777386549726,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Rhinol\ufffdAllergy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic rhinosinusitis with nasal polyps (CRSwNP) presents significant management challenges, largely due to reliance on systemic corticosteroids (SCS) for symptom control. Advances in biologic therapies targeting type 2 inflammation have shown promise in reducing polyp burden, improving symptoms, and decreasing the need for SCSs and surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis compare the steroid-sparing efficacy of biologics and safety with other biologics or standard care in CRSwNP. Key outcomes include reducing SCS Use and drug safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Cochrane Library, Scopus, and the Web of Science. We included randomized controlled trials (RCTs) comparing biologics versus placebo\/standard care in adults with CRSwNP. The primary outcomes were SCS reduction and safety. Meta-analyses, which use a statistical method called random effects models, were employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This meta-analysis of seven RCTs (n\u2009=\u20093097) revealed that biologic therapies significantly reduce SCS use in CRSwNP patients (pooled proportion: 20.9%, 95% CI: 8.4%-37.0%), though with substantial heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200998.3%). Trial-level predictors included control-arm safety profiles (higher serious adverse events (SAEs) reduced treatment effects) [odds ratio (OR) 0.70]. In contrast, placebo-arm SAEs enhanced them [OR 1.81]) and sample size (larger trials showed diluted responses [OR 0.993 per patient]). These results highlight the role of trial design and baseline patient risk in determining the interest of the results. They further highlight the possibility for individualized strategies in terms of treatment and call for more in-depth studies with patient-level data to refine the steroid-sparing therapeutic strategy, providing an impetus for future work in this area.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The biologics, specifically dupilumab, represent a paradigm shift in treating CRSwNP, significantly decreasing the burden of SCS\u2014their consistent safety and efficacy support integration into treatment algorithms for severe cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19458924251414922","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T18:53:42Z","timestamp":1768330422000},"page":"245-256","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Steroid-Sparing Effects of Biologics in Chronic Rhinosinusitis with Nasal Polyps: Systematic Review and A Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2151-8198","authenticated-orcid":false,"given":"Ali M.","family":"Alsudays","sequence":"first","affiliation":[{"name":"King Saud University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0970-8895","authenticated-orcid":false,"given":"Yasser G.","family":"Alarimah","sequence":"additional","affiliation":[{"name":"King Saud Medical City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3626-4721","authenticated-orcid":false,"given":"Khaled A.","family":"Almanea","sequence":"additional","affiliation":[{"name":"Prince Sultan Military Medical City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5275-0255","authenticated-orcid":false,"given":"Ahmad","family":"Alroqi","sequence":"additional","affiliation":[{"name":"King Saud University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/all.13875"},{"key":"e_1_3_4_3_2","unstructured":"Khan A Huynh TMT Vandeplas G et al. The GALEN rhinosinusitis cohort: chronic rhinosinusitis with nasal polyps affects healthrelated quality."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin20.401"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S290424"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin17.255"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13601-019-0269-4"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348941011900705"},{"key":"e_1_3_4_9_2","first-page":"109","article-title":"Twelve-year long-term postoperative outcomes in patients with chronic rhinosinusitis with nasal polyps","volume":"60","author":"Arancibia C","year":"2022","unstructured":"Arancibia C, Langdon C, Mullol J, Alobid I. Twelve-year long-term postoperative outcomes in patients with chronic rhinosinusitis with nasal polyps. Rhinology. 2022;60(2):109\u2013117.","journal-title":"Rhinology"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1403291"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703501"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1804093"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.01.00092101"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1702079"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.2217\/imt-2021-0310"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(21)00097-7"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.05.032"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.77804"},{"key":"e_1_3_4_19_2","doi-asserted-by":"crossref","unstructured":"Chupp GL Alobid I Lugogo NL et al. Mepolizumab reduces systemic corticosteroid use in chronic rhinosinusitis with nasal polyps. 2023.","DOI":"10.1016\/j.jaip.2023.08.015"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/cl2.1230"},{"key":"e_1_3_4_21_2","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. 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