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 omalizu-mab 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 bio-logics 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.