SynthesisFrontiers in medicine2026
Predictive biomarkers of biologic therapy response in chronic rhinosinusitis with nasal polyps: a systematic review.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Biologic therapies have transformed management of severe chronic rhinosinusitis with nasal polyps (CRSwNP), but response variability persists. Baseline biomarkers may identify patients most likely to benefit, yet no marker is validated for routine clinical use. This systematic review evaluated baseline biomarkers predicting clinical and endoscopic response to biologic therapy in adults with CRSwNP. Methods: A systematic search identified studies reporting baseline biomarkers and response to biologics (dupilumab, omalizumab, anti-IL-5 agents) in adult CRSwNP. Ten studies with 489 participants met inclusion criteria. Data extraction included biomarker type, thresholds, outcomes [SNOT-22, nasal polyp score (NPS), radiologic scores], and follow-up duration. Random-effects meta-analysis was performed for dichotomized high vs. low baseline eosinophil counts. Certainty of evidence was assessed using GRADE. Results: Meta-analysis demonstrated that elevated eosinophils (>300 cells/µL or study-defined high) increased odds of SNOT-22 improvement (OR 3.07, 95% CI 2.00-4.72, Conclusion: Current evidence, though limited by low certainty, suggests baseline peripheral eosinophil count is the most consistent predictor of biologic response in CRSwNP. These findings support further investigation of eosinophils as a potential predictive biomarker, but prospective validation is needed before clinical implementation. Other biomarkers showed inconsistent predictive value across studies. Systematic Review Registration: PROSPERO CRD420251251904.
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