Summary

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• This summary is based on the review of 68 systematic review(s)/meta-analysis(es). ^[1-68]
• Chronic Rhinosinusitis with Nasal Polyps (CRSwNP): Dupilumab demonstrated the highest efficacy in improving the nasal polyp score (NPS), Sino-Nasal Outcome Test-22 (SNOT-22), University of Pennsylvania Smell Identification Test (UPSIT), and nasal congestion score (NCS), outperforming omalizumab and mepolizumab.
• Eosinophilic Otitis Media: Biologic treatments, including dupilumab, significantly improved otitis media-related subjective scores and reduced serum eosinophil and IgE levels. Hearing thresholds remained unchanged, and no significant differences were observed between dupilumab and other biologics.
• Atopic Dermatitis (AD): Dupilumab significantly reduced the Eczema Area and Severity Index (EASI) score and improved quality of life across age groups. EASI-75 achievement rates varied between age cohorts. Dupilumab was more effective than systemic immunosuppressants like methotrexate and cyclosporine and comparable to other biologics.
• Asthma: Dupilumab significantly reduced severe asthma exacerbations and improved lung function (forced expiratory volume in 1 second (FEV₁)). Its effectiveness was comparable to tezepelumab in these measures.
• CRSwNP: Dupilumab was associated with an increased risk of injection-site reactions but a lower risk of asthma worsening compared to other biologics. Dupilumab posed a higher risk of injection-site reactions than placebo and other biologics such as lebrikizumab and benralizumab.
• AD: Common adverse events with dupilumab included conjunctivitis and nasopharyngitis. Dupilumab demonstrated a favorable safety profile compared to systemic immunosuppressants, with similar rates of severe adverse events as other biologics like tralokinumab and abrocitinib. Pediatric safety profiles were consistent with those observed in adults.
• Asthma: Dupilumab was linked to increased blood eosinophils, but no significant differences in other adverse events were observed compared to placebo. Its safety profile was comparable to other biologics such as tezepelumab and benralizumab.
• Studies on CRSwNP included primarily adult patients, often with comorbid asthma, with no specific subgroup differences in effectiveness or safety reported beyond the general population findings.
• For AD, studies covered a range of age groups, from infants to adults. Pediatric and adolescent patients had varying rates of EASI-75 achievement, though safety profiles were consistent across age groups.