Real-world treatment of chronic rhinosinusitis with dupilumab and omalizumab: results from the Korean National Health Insurance Service database

BACKGROUND: Biological treatment has proven effective for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) and is increasingly prescribed. However, in the real-world, strict adherence to the recommended dose may not be feasible and studies on the actual administration patterns of biologics are limited. This study aimed to evaluate the patterns of real-world use of biologics for CRS in Korea, through the National Health Insurance Service (NHIS). METHODS: We analysed data from the NHIS database from January 2010 to March 2024. Patients with CRS or nasal polyp defined by the ICD-10 codes, who had undergone computed tomography, and had a history of being prescribed dupilumab or omalizumab were identified. A total of 808 patients were analysed for their administration patterns and systemic corticosteroid use. RESULTS: Twelve weeks after initiation of therapy, 46.2% of patients received dupilumab at 2-weekly intervals and 53.9% of patients on omalizumab patients were receiving treatment at 2- or 4-week intervals. The annual expense of CRS patients treated with biologics was greater than for those receiving other treatments. The average annual usage of systemic steroids was decreased from 33.0 days to 12.7 days after using biologics. CONCLUSIONS: The results of this study which analysed real-world data in a large population, suggest a discrepancy between the recommended dose and real-world administration of biologics. Further studies are warranted on feasible administration schedules that reflect various patient factors and healthcare costs.