Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have atopic comorbidities, including elevated immunoglobulin E (IgE) levels and comorbid asthma. Omalizumab, an IgE monoclonal antibody, is an effective treatment for CRSwNP, but the impact of allergy or asthma status on response to omalizumab in patients with CRSwNP has not been well studied.
To evaluate the impact of the allergic and asthma status on omalizumab treatment in patients with CRSwNP, this post hoc exploratory analysis assessed sinonasal outcomes from subgroups of patients included in POLYP 1 and POLYP 2 and the open-label extension (OLE) trials.
Patients (N = 249) were grouped by presence/absence of comorbid allergy (≥ 1 physician-reported allergic rhinitis, allergic sinusitis, food allergy, atopic dermatitis), presence/absence of comorbid asthma, baseline serum total IgE (≥ 150 or < 150 IU/mL), and baseline blood eosinophil levels (> 300 or ≤ 300 cells/µL). Sinonasal outcomes were the Nasal Polyps Score (NPS), Nasal Congestion Score (NCS), and Sino-Nasal Outcome Test-22 (SNOT-22).
During POLYP 1 and POLYP 2 and the OLE, omalizumab treatment improved NPS, NCS, and SNOT-22 in patients with/without physician-reported allergic comorbidities, with/without asthma, with higher/lower total IgE levels, and with higher/lower blood eosinophil counts. In the OLE, the pattern of improvement was similar in patients who continued or switched to omalizumab.
In patients with CRSwNP, omalizumab improved sinonasal outcomes independent of allergic status, which suggests that a wide range of patients with different endotypes and phenotypes of CRSwNP may benefit from omalizumab treatment.

Copyright © 2023. Published by Elsevier Inc.