Recent Advances in Biologic Therapy for Chronic Rhinosinusitis

Abstract

Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disorder of the sinonasal mucosa, characterized by symptoms including nasal obstruction, rhinorrhea, olfactory dysfunction, and facial pain. Phenotypically, it is classified into two subtypes: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). Despite the availability of conventional treatments such as intranasal corticosteroids, antibiotics, and endoscopic sinus surgery, a substantial proportion of patients (30%–50%) experience recurrent or refractory disease. CRSwNP, in particular, poses a significant therapeutic challenge. The period between 2020 and 2025 witnessed groundbreaking progress in the development and clinical application of biologics targeting type 2 inflammation, driving a paradigm shift in CRS management from empirical therapy to precision medicine. This period also saw synergistic and complementary advances in both Chinese and international research. This article systematically reviewed key studies published in high-impact journals between 2020 and 2025, focusing on the mechanisms of action, clinical efficacy, safety profiles, individualized treatment strategies, and global application of biologics for CRS. Furthermore, it provided a comparative analysis of research findings and guideline consensus from China and other countries, discussed ongoing controversies and future research directions, and offered insights to guide clinical practice and inform scientific inquiry.