Uso de Terapias Biológicas (anticorpos Monoclonais) em Rinossinusite Crônica com Polipose Nasal

Thais Gutierrez do Amaral Coelho; Gustavo Alexandre Romero Tenório; Marcela Beerli Gazzoni; Marina Melo Cavalcante

doi:10.36489/nursing.2025v30i328p11699-11710

Authors

Thais Gutierrez do Amaral Coelho Universidad Cristiana de Bolivia https://orcid.org/0009-0003-5769-4410
Gustavo Alexandre Romero Tenório Pontifícia Universidade Católica de Minas Gerais; campus Poços de Caldas https://orcid.org/0000-0002-6636-7353
Marcela Beerli Gazzoni Faculdade Brasileira Multivix - vitória; ano de formatura 2019 https://orcid.org/0009-0006-9558-6877
Marina Melo Cavalcante UNIFIMES https://orcid.org/0000-0001-5403-8299

DOI:

https://doi.org/10.36489/nursing.2025v30i328p11699-11710

Keywords:

Chronic Rhinosinusitis, Nasal Polyps, Monoclonal Antibodies

Abstract

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is often driven by type-2 inflammation and recurs despite steroids and/or surgery. Objective: To synthesize evidence on efficacy, safety, indications, and monitoring of monoclonal antibodies in CRSwNP. Methods: Narrative literature review (PubMed, SciELO, Web of Science) through Oct 14, 2025, emphasizing phase-III RCTs, guidelines/consensus statements, and real-world studies. Results: Dupilumab (anti-IL-4Rα) improved nasal polyp score, congestion, and CT opacification in two phase-III trials (SINUS-24/52), with consistent effects across subgroups; omalizumab (anti-IgE) improved endoscopic and patient-reported outcomes (POLYP-1/2) and is approved as add-on therapy; mepolizumab (anti-IL-5) reduced polyp size and surgery need (SYNAPSE); benralizumab (anti-IL-5Rα) improved NPS, congestion, and smell (OSTRO); tezepelumab (anti-TSLP) showed significant reductions in NPS, congestion, and systemic steroid/surgery use in 2025 data. Conclusions: Biologics are effective and safe for uncontrolled type-2 CRSwNP; patient selection should consider phenotype/endotype, comorbid asthma/NSAID-ERD, and contemporary response criteria.

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