ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025
Prescriptions of biologics in patients with chronic rhinosinusitis with nasal polyps in Germany (2019-2023).
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundChronic rhinosinusitis with nasal polyps (CRSwNP) is often associated with type 2 inflammation and has significant impact on quality of life. Since 2019, biologics targeting type 2 pathways have been approved as add-on therapy for severe, treatment-refractory CRSwNP. However, the development of biologic prescribing patterns in Germany since their approval has not yet been systematically analyzed. METHODOLOGY: Diagnosis and prescription data of all residents with statutory health insurance (SHI) in Germany were analyzed for 2019-2023. Patients diagnosed with chronic rhinosinusitis (CRS, ICD-10: J32 and/or J33) and CRSwNP (ICD-10: J32 and J33) treated ENT specialists were included. We assessed case numbers, biologic prescriptions (Dupilumab, Omalizumab, Mepolizumab), biologic-treated patients per physician, and proportions among CRS/CRSwNP patients. Demographic variables (age, sex, residence) were also analyzed.
resultsCRS and CRSwNP case numbers declined in 2020 but increased thereafter. Biologic prescriptions rose from < 0.1% in 2019 to ~ 5% of CRSwNP patients in 2023. Biologic-treated patients per physician increased from 2.59 to 13.34 (SD: 19.78) in CRSwNP and from 3.78 to 18.41 (SD: 27.09) in CRS. Omalizumab was most prescribed in 2019 (55%), but Dupilumab dominated from 2020 onward (86-94%). Mepolizumab use rose to 5-10% in 2022-2023. Biologic-treated patients were younger than those without (53.2 vs. 56.1 years; p < 0.001). Rural patients had slightly higher CRSwNP prevalence but lower biologic use.
conclusionsBiologic use in CRSwNP increased substantially. Age and regional differences suggest disparities in access or prescribing patterns.
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