A recent systematic review and network meta-analysis examined 19 randomized controlled trials involving 2,354 patients to determine which pharmacologic therapies best improve olfactory dysfunction in chronic rhinosinusitis with nasal polyps (CRSwNP). Across all treatment classes, biologics delivered the strongest gains in both subjective and objective olfactory outcomes, outperforming standard therapies and placebo. Dupilumab emerged as the most effective agent, demonstrating substantial improvements in quantitative smell tests and patient-reported outcomes.
The findings reinforce the central role of type-2 inflammatory pathways in CRSwNP-associated olfactory loss and position biologics, particularly dupilumab as leading therapeutic options. Still, the authors emphasize the need for standardized olfactory assessment tools and larger, multicentric RCTs to refine clinical decision-making.…
