Kolkhir P, Akdis CA, Akdis M, Bachert C, Bieber T, Canonica GW, et al. Type 2 chronic inflammatory diseases: targets, therapies and unmet needs. Nat Rev Drug Discov. 2023;22(9):743–67. https://doi.org/10.1038/s41573-023-00750-1.

Article  CAS  PubMed  Google Scholar 

De Corso E, Pasquini E, Trimarchi M, La Mantia I, Pagella F, Ottaviano G, et al. Dupilumab in the treatment of severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP): A multicentric observational phase IV real-life study (DUPIREAL). Allergy. 2023;78(10):2669–83. https://doi.org/10.1111/all.15772.

Article  CAS  PubMed  Google Scholar 

Agache I, Akdis CA, Akdis M, Canonica GW, Casale T, Chivato T, et al. EAACI biologicals Guidelines-Recommendations for severe asthma. Allergy. 2021;76(1):14–44. https://doi.org/10.1111/all.14425.

Article  PubMed  Google Scholar 

Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018;32(5):657–82. https://doi.org/10.1111/jdv.14891.

Article  CAS  PubMed  Google Scholar 

Dellon ES, Rothenberg ME, Collins MH, Hirano I, Chehade M, Bredenoord AJ, et al. Dupilumab in adults and adolescents with eosinophilic esophagitis. N Engl J Med. 2022;387(25):2317–30. https://doi.org/10.1056/NEJMoa2205982.

Article  CAS  PubMed  Google Scholar 

Schleimer RP, Berdnikovs S. Etiology of epithelial barrier dysfunction in patients with type 2 inflammatory diseases. J Allergy Clin Immunol. 2017;139(6):1752–61. https://doi.org/10.1016/j.jaci.2017.04.010.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Noda S, Krueger JG, Guttman-Yassky E. The translational revolution and use of biologics in patients with inflammatory skin diseases. J Allergy Clin Immunol. 2015;135(2):324–36. https://doi.org/10.1016/j.jaci.2014.11.015.

Article  CAS  PubMed  Google Scholar 

Ciofalo A, Loperfido A, Baroncelli S, Masieri S, Bellocchi G, Caramia R, et al. Comparison between clinical and cytological findings in chronic rhinosinusitis with nasal polyps treated with dupilumab. Eur Arch Otorhinolaryngol. 2024;281(12):6511–21. https://doi.org/10.1007/s00405-024-08958-6.

Article  PubMed  Google Scholar 

Sugita K, Steer CA, Martinez-Gonzalez I, Altunbulakli C, Morita H, Castro-Giner F, et al. Type 2 innate lymphoid cells disrupt bronchial epithelial barrier integrity by targeting tight junctions through IL-13 in asthmatic patients. J Allergy Clin Immunol. 2018;141(1):300–e1011. https://doi.org/10.1016/j.jaci.2017.02.038.

Article  CAS  PubMed  Google Scholar 

Bachert C, Bhattacharyya N, Desrosiers M, Khan AH. Burden of disease in chronic rhinosinusitis with nasal polyps. J Asthma Allergy. 2021;14:127–34. https://doi.org/10.2147/JAA.S290424.

Article  CAS  PubMed  PubMed Central  Google Scholar 

De Corso E, Settimi S, Montuori C, Cantiani A, Corbò M, Di Bella GA, et al. How to manage recurrences after surgery in CRSwNP patients in the biologic era: a narrative review. Acta Otorhinolaryngol Ital. 2023;43(Suppl1):S3–13. https://doi.org/10.14639/0392-100X-suppl.1-43-2023-01.

Article  PubMed  PubMed Central  Google Scholar 

Vanderhaegen T, Gengler I, Dendooven A, Chenivesse C, Lefèvre G, Mortuaire G. Eosinophils in the field of nasal polyposis: towards a better Understanding of biologic therapies. Clin Rev Allergy Immunol. 2022;62(1):90–102. https://doi.org/10.1007/s12016-021-08844-7.

Article  CAS  PubMed  Google Scholar 

De Corso E, Bellocchi G, De Benedetto M, Lombardo N, Macchi A, Malvezzi L, et al. Biologics for severe uncontrolled chronic rhinosinusitis with nasal polyps: a change management approach. Consensus of the joint committee of Italian society of otorhinolaryngology on biologics in rhinology. Acta Otorhinolaryngol Ital. 2022;42(1):1–16. https://doi.org/10.14639/0392-100X-N1614.

Article  PubMed  Google Scholar 

Lommatzsch M, Brusselle GG, Canonica GW, Jackson DJ, Nair P, Buhl R, et al. Disease-modifying anti-asthmatic drugs. Lancet. 2022;399(10335):1664–8. https://doi.org/10.1016/S0140-6736(22)00331-2.

Article  PubMed  Google Scholar 

U.S. Food and Drug Administration (FDA)-Approved Drugs. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm Accessed 10 May 2025.

Chen MM, Roufosse F, Wang SA, Verstovsek S, Durrani SR, Rothenberg ME, et al. An international, retrospective study of Off-Label biologic use in the treatment of hypereosinophilic syndromes. J Allergy Clin Immunol Pract. 2022;10(5):1217–e283. https://doi.org/10.1016/j.jaip.2022.02.006.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Little DHW, Tabatabavakili S, Shaffer SR, Nguyen GC, Weizman AV, Targownik LE. Effectiveness of dose De-escalation of biologic therapy in inflammatory bowel disease: A systematic review. Am J Gastroenterol. 2020;115(11):1768–74. https://doi.org/10.14309/ajg.0000000000000783.

Article  PubMed  Google Scholar 

Lasheras-Pérez MA, Palacios-Diaz RD, González-Delgado VA, Cobreros LV, Pereira-Resquin Galván GO, Miquel-Miquel J, et al. Dose tapering of dupilumab in patients with persistently controlled atopic dermatitis: a Spanish multicenter cohort study. Int J Dermatol. 2024;63(3):402–4. https://doi.org/10.1111/ijd.17030.

Article  CAS  PubMed  Google Scholar 

Ardern-Jones MR, Buchanan EE, Njungu S, O’Driscoll D. Successful dose reduction of dupilumab in atopic dermatitis. Br J Dermatol. 2023;188(5):678–9. https://doi.org/10.1093/bjd/ljad011.

Article  PubMed  Google Scholar 

Meyer MK, Andersen M, Ring T, Andersen GN, Ehlers LH, Rasmussen C, et al. Personalized rheumatic medicine through dose reduction reduces the cost of biological treatment - a retrospective intervention analysis. Scand J Rheumatol. 2019;48(5):398–407. https://doi.org/10.1080/03009742.2019.1585940.

Article  CAS  PubMed  Google Scholar 

Fokkens WJ, Viskens AS, Backer V, Conti D, De Corso E, Gevaert P, et al. EPOS/EUFOREA update on indication and evaluation of biologics in chronic rhinosinusitis with nasal polyps 2023. Rhinology. 2023;61(3):194–202. https://doi.org/10.4193/Rhin22.489.

Article  CAS  PubMed  Google Scholar 

Isabwe GAC, Garcia Neuer M, de Las Vecillas Sanchez L, Lynch DM, Marquis K, Castells M. Hypersensitivity reactions to therapeutic monoclonal antibodies: phenotypes and endotypes. J Allergy Clin Immunol. 2018;142(1):159–. https://doi.org/10.1016/j.jaci.2018.02.018.  70.e2.

Article  CAS  PubMed  Google Scholar 

Fokkens WJ, De Corso E, Backer V, Bernal-Sprekelsen M, Bjermer L, von Buchwald C, et al. EPOS2020/EUFOREA expert opinion on defining disease States and therapeutic goals in CRSwNP. Rhinology. 2024;62(3):287–98. https://doi.org/10.4193/Rhin23.415.

Article  CAS  PubMed  Google Scholar 

Hellings PW, De Corso E, Backer V, Bernal-Sprekelsen M, Chan Y, Conti DM, et al. Remission in chronic rhinosinusitis with nasal polyps (CRSwNP). Rhinology. 2025;63(2):239–41. https://doi.org/10.4193/Rhin24.457.

Article  CAS  PubMed  Google Scholar 

Otten JJ, Elzinga HE, van der Lans RJL, Fokkens WJ, Reitsma S, PolyREG Consortium. Almost half of the Dupilumab-Treated patients with severe chronic rhinosinusitis with nasal polyps achieve remission in one year. Allergy. 2025;80(4):1166–8. https://doi.org/10.1111/all.16496.

Article  CAS  PubMed  Google Scholar 

Caminati M, De Corso E, Ottaviano G, Pipolo C, Schiappoli M, Seccia V, et al. Remission in type 2 inflammatory diseases: current evidence, unmet needs, and suggestions for defining remission in chronic rhinosinusitis with nasal polyps. Curr Allergy Asthma Rep. 2024;24(1):11–23. https://doi.org/10.1007/s11882-023-01118-6.

Article  PubMed  Google Scholar 

Lommatzsch M, Blumchen K, Beck LA, Bousquet J, Brusselle GG, Fokkens WJ, et al. Roads to remission: evolving treatment concepts in type 2 inflammatory diseases. EClinicalMedicine. 2025;80:103050. https://doi.org/10.1016/j.eclinm.2024.103050.

Article  PubMed  PubMed Central  Google Scholar 

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71.

Article  PubMed