Document Type

Article

Publication Date

2026

DOI

10.1007/s12325-026-03655-8

Publication Title

Advances in Therapy

Volume

Advance online publication

Pages

18 pp.

Abstract

Introduction

This study compared the efficacy of tezepelumab with other approved biologics and endoscopic sinus surgery (ESS) using indirect treatment comparisons (ITCs) in adults with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods

Randomized controlled trials (RCTs) identified via a systematic literature review (SLR) were synthesized in a network meta-analysis (NMA). Outcomes included change from baseline in nasal polyp score (NPS), nasal congestion/obstruction score (NCS/NOS), difficulty with sense of smell (DSS), Sino-Nasal Outcome Test-22 (SNOT-22) score, Lund Mackay score (LMS), time to nasal polyposis (NP) surgery decision, proportions requiring NP surgery or systemic corticosteroids (SCS), time to SCS use, and the University of Pennsylvania Smell Identification Test (UPSIT). Mean differences, hazard ratios, and odds ratios with 95% credible intervals were estimated for available treatments at 52 weeks. Not all endpoints were reported across trials; comparisons were conducted only where both treatments reported the outcome.

Results

At 52 weeks, tezepelumab showed comparable efficacy to dupilumab across all evaluated endpoints, apart from the proportion of patients requiring surgery, where tezepelumab was associated with a lower surgery rate than dupilumab. Tezepelumab consistently outperformed mepolizumab, depemokimab, and placebo. In analyses of <  30-week endpoints, tezepelumab outperformed omalizumab for all outcomes except SNOT-22, where no difference was observed. Sensitivity analyses including ESS showed benefits for tezepelumab across endpoints except for NPS, for which ESS ranked highest.

Conclusion

Tezepelumab achieved similar efficacy to dupilumab across all evaluated endpoints with the exception of the proportion of patients requiring surgery, where tezepelumab demonstrated a numerically greater reduction compared with dupilumab. Results consistently favoured tezepelumab and dupilumab over depemokimab, mepolizumab, and omalizumab.

Rights

© 2026 The Authors.

This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original authors and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Data Availability

Article states: "The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request."

Original Publication Citation

Han, J. K., Mullol, J., Hopkins, C., Pfaar, O., Desrosiers, M., Steenkamp, J., Gibson, D., Sanchez, S. Z., Foster, A., & Ambrose, C. S. (2026). Indirect treatment comparison of tezepelumab versus other biologics in severe chronic rhinosinusitis with nasal polyps: A systematic literature review and network meta-analysis. Advances in Therapy. Advance online publication. https://doi.org/10.1007/s12325-026-03655-8

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