Comparative efficacy of combined steroid and omalizumab therapy following the surgical treatment of chronic polypous rhinosinusitis in adults

Introduction
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the mucous membrane of the nose and adjacent cavities. In the treatment of the condition, glucocorticoids are considered a traditional and effective therapeutic drug. Monoclonal antibodies are a promising therapeutic option because they can block specific chemokines.

Aim
The aim of the presented study is to assess the comparative efficacy of CRSwNP therapy with combined use of steroids and a biologic agent, omalizumab.

Material and methods
One hundred and four participants diagnosed with chronic rhinosinusitis who underwent excision of polyps were involved in two interventional groups of the study. The first group (ST-group) included 56 patients who received 2 injections of Diprospan,whilethe other group (STO-group) received combined therapy with omalizumab and Diprospan. Sino-Nasal Outcome Test 22 (SNOT-22), assessment of skin functional properties, Modified Lund-Mackay Postoperative Endoscopy Score (MLMES) and computed tomography of nasal sinuses were used to comparatively evaluate the treatment efficacy.

Results
The STO-group showed statistically significant improvements across all measured parameters. This suggests that omalizumab may enhance the therapeutic effect of corticosteroids, potentially by stabilizing mast cells and decreasing allergic inflammatory responses more broadly.

Conclusions
While more research is necessary to evaluate the cost-effectiveness and long-term safety of this approach, current evidence supports its potential as a more effective treatment modality for severe or refractory cases of CRS. The addition of omalizumab allows for lower cumulative steroid exposure, reducing long-term side effects while maintaining or improving efficacy.