Biologics in Chronic Rhinosinusitis With Nasal Polyposis
Chronic Sinusitis · Nasal Polyps
What this study involves
The registry says this study is recruiting. Individual locations may have different availability.
- Study type
- Interventional
- Phase
- Phase 4
- Age range
- 18 years - Not specified
- Sex eligible
- All sexes
- Healthy volunteers
- Not accepted
- Participants
- 504 Estimated
These are starting points, not an eligibility decision. The research team must review the full requirements.
About the research
The prevalence of Chronic Sinusitis with Nasal Polyps (CRSwNP) in the United States is estimated at roughly 4%, which equates to over 13 million Americans. Until recently, the only medical treatment options available for patients with CRSwNP were corticosteroids, with surgery reserved for medical failure. The development of biologic medications over the last 5 years has revolutionized the treatment of CRSwNP. Three biologic medications have been FDA approved and available for the treatment of CRSwNP: dupilumab, omalizumab, and mepolizumab. However, data from the clinical trials for these drugs do not show universal improvement across all patients with CRSwNP. In fact, there is a wide range of outcomes for patients in these trials. The result is that clinicians have no way of knowing which specific biologic would be the best option for any given patient, nor do they know whether biomarkers can be used to predict response to biologics. It is hoped that findings from this study will inform whether any one biologic has superior outcomes to another and whether clinicians can identify patients at baseline who are most likely to improve on biologic therapy.
Who may be able to participate?
The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.
Inclusion Criteria:
- Age \> 18 years
- Confirmed diagnosis of chronic rhinosinusitis with nasal polyposis using ICAR-21 (International Consensus Statement 20215) criteria
- Bilateral nasal polyposis visible on sinonasal endoscopy
- Nasal polyp score \> 5
- Baseline SNOT-22 total score \> 30
- Patient elects biologic therapy for the management of CRSwNP
- Capable of receiving all 3 biologic therapy medications.
- Treatment with intranasal mometasone ≥200 μg. once daily (or equivalent of another intranasal corticosteroid) for 1-month prior to baseline visit.
Exclusion Criteria:
- Inability or unwillingness of a participant to give written informed consent or comply with study protocol
- Endoscopic sinus surgery within 6-months preceding enrollment / randomization.
- Oral corticosteroid use within 30-days preceding enrollment / randomization.
- Serum IgE level outside the dosing range for omalizumab (i.e., \<30 IU/ml. or a weight-based dose with insufficient data to determine dose as per FDA dosing chart)
- Comorbid atopic dermatitis, urticaria, or any other condition that would require a specific biologic per the standard of care.
- Currently pregnant or plan to become pregnant within the 6 months after enrollment / randomization.
- Any previous treatment with any of the 3 biologic medications.
- Comorbid cystic fibrosis, CVID, or ciliary dyskinesia.
- Comorbid systemic inflammatory disorders (e.g., GPA, EGPA, Sarcoidosis, SLE)
- Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks for participation in the study, may interfere with the participant's ability to comply with study requirements, or that may impact the quality or interpretation of the data obtained from the study.
Treatment, groups and participation
The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.
- Assignment
- Random assignment
- Masking
- No masking
Dupilumab
Not reported in this registry record.
Biological: Biologic Agents
Omalizumab
Not reported in this registry record.
Biological: Biologic Agents
Mepolizumab
Not reported in this registry record.
Biological: Biologic Agents
Biologic Agents BIOLOGICAL
Evidence by way of phase III clinical trials has shown efficacy of dupilumab, omalizumab, and mepolizumab to placebo, leading to regulatory approval and widespread clinical use. However, data from these clinical trials does not show universal improvement and ideal control of disease across all patients with Chronic Sinusitis with Nasal Polyps (CRSwNP). Successful completion of this trial will help answer some of the most pressing clinical questions related to biologics and CRSwNP. Specifically, findings will inform whether any one biologic has superior outcomes to another and whether clinicians can identify patients at baseline who are most likely to improve on biologic therapy.
What researchers are measuring
Outcome measures describe what is being studied. They are not proof that a treatment works.
Primary measures
Disease-Specific Quality of Life
Time frame: 24 weeks
The 22-item SinoNasal Outcome Test (SNOT-22; ©2006, Washington University, St. Louis, MO) will serve as the primary outcome of interest for all study aims/objectives. The SNOT-22 survey is a CRS-specific QOL instrument containing 22 questions (total summarized score range: 0-110) with high internal consistency and high test-retest reliability. The SNOT-22 utilizes Likert scales numbering from 0 ("No problem") to 5 "Problem as bad as it can be"). The SNOT-22 has been shown to discriminate between subjects with CRS and healthy controls, as well as identify significant differences after both medical and surgical treatments.
Review the complete result tables and limitations in the official record.
Open official results ↗Research locations (5)
The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.
5 locations
Mayo Clinic ArizonaPhoenix, Arizona, United StatesRecruiting
UF Health ENT and Allergy - The OaksGainesville, Florida, United StatesRecruiting
Oregon Health and Science UniversityPortland, Oregon, United StatesRecruiting
Medical University of South CarolinaCharleston, South Carolina, United StatesRecruiting
Vanderbilt University Medical CenterNashville, Tennessee, United StatesRecruiting
Study team and timeline
- Lead sponsor
- Medical University of South Carolina
- Study start
- Jun 3, 2026 Actual
- Primary completion
- 2030-02 Estimated
- Study completion
- 2030-02 Estimated
- First posted
- Feb 13, 2025 Actual
- Last updated
- Nov 10, 2026 Actual
Official study contacts
Official study title
SMART Use of Biologics in Chronic Rhinosinusitis With Nasal Polyposis
Ask Wellness Clinical Research
Your message goes to WCR, including when this study is run by another organization. WCR may offer general guidance but may not operate this trial, have access to its team or be able to enroll you.
Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.
Retrieved: Nov 12, 2026 · Last registry update: Nov 10, 2026
