RECENT FINDINGS: Due to the heterogeneity of diseases, biologic therapies may efficiently control CRSwNP but give inadequate control for asthma, or vice versa. Changing an ineffective first-line biologic to a second-line treatment or others is generally referred to as switching. The most common reasons for switching biologics are poor symptom management or ineffectiveness, and undesirable adverse effects. The ineffectiveness was largely due to the use of omalizumab or mepolizumab, whereas the adverse effects were due to dupilumab.
SUMMARY: Switching biologics is a nuanced process influenced by a variety of patient-specific and clinical factors. Biologics that effectively treat upper and lower airway diseases are recommended for optimal control in CRSwNP patients with concurrent asthma. There was no difference in outcomes between switching biologics with and without a washout period. Switching between biologics in the same class is generally not recommended. Dupilumab serves as an effective treatment option for refractory cases particularly aspirin-exacerbated respiratory disease.
RECENT FINDINGS: There were more Asian studies which reported lower prevalence (0-20%), in contrast to higher rates in Europe, particularly Mediterranean countries. Urbanization, air pollution, and high dust mite exposure may be important factors of nonatopic rhinitis in Asia. Diagnostic approaches, including nasal-specific IgE and provocation tests, vary across studies, impacting prevalence estimates.
SUMMARY: The lower reported LAR prevalence in Asia suggests potential differences in underlying mechanisms or diagnostic limitations. Further research is needed to refine diagnostic criteria, explore environmental triggers, and assess the clinical relevance of LAR in Asian populations. A better understanding of LAR in Asia could guide targeted management strategies and improve recognition of this condition in clinical practice.