Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition characterized by type 2 (T2) immune responses with significant impacts on quality of life and healthcare costs. Local IgE production in nasal polyp tissue plays a key role in the T2 inflammatory cascade. Omalizumab, an anti-IgE monoclonal antibody, is an effective treatment for some patients with CRSwNP regardless of the patient's allergic status. Clinical trials, including pivotal POLYP 1 and POLYP 2 studies, demonstrated omalizumab's efficacy in reducing nasal polyp size, improving symptom scores, and enhancing quality of life, particularly in patients with comorbid asthma and aspirin-exacerbated respiratory disease (AERD). As we summarize in this review, omalizumab's effect appears to involve the reduction in local IgE and T2 inflammation; however, this remains poorly understood. Notably, omalizumab's effectiveness appears to be partially sustained after long-term use, though symptoms and inflammation begin to return upon discontinuation. Ongoing research is needed to determine the optimal duration of therapy and potential for biologics to modify the disease course. Additionally, further studies are needed to identify biomarkers to predict treatment response and to compare omalizumab with other biologics such as dupilumab, in head-to-head trials. Omalizumab is one of the key T2-targeted therapeutic options for CRSwNP with sustained effectiveness and strong safety profile.

中文翻译：

---

慢性鼻窦炎伴鼻息肉的抗 IgE 治疗。


慢性鼻-鼻窦炎伴鼻息肉 （CRSwNP） 是一种慢性炎症性疾病，其特征是 2 型 （T2） 免疫反应，对生活质量和医疗保健费用有重大影响。鼻息肉组织中局部 IgE 的产生在 T2 炎症级联反应中起关键作用。奥马珠单抗是一种抗 IgE 单克隆抗体，对于一些 CRSwNP 患者来说是一种有效的治疗方法，无论患者的过敏状态如何。临床试验，包括关键的 POLYP 1 和 POLYP 2 研究，证明了奥马珠单抗在减少鼻息肉大小、改善症状评分和提高生活质量方面的疗效，尤其是在合并哮喘和阿司匹林加重呼吸系统疾病 （AERD） 的患者中。正如我们在本综述中总结的那样，奥马珠单抗的作用似乎涉及减少局部 IgE 和 T2 炎症;然而，人们对此仍然知之甚少。值得注意的是，奥马珠单抗的有效性似乎在长期使用后部分维持，尽管停药后症状和炎症开始复发。需要进行持续的研究来确定最佳治疗持续时间和生物制剂改变病程的潜力。此外，还需要进一步研究来确定生物标志物以预测治疗反应，并在头对头试验中将奥马珠单抗与 dupilumab 等其他生物制剂进行比较。奥马珠单抗是 CRSwNP 的关键 T2 靶向治疗选择之一，具有持续的有效性和强大的安全性。