International Rhinologic Society Rhinology 0300-0729 2026 04 02 Real-world epidemiological outcomes of biologic therapy for chronic rhinosinusitis with nasal polyps: a big data analysis EN E. ZloczowerDepartment of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel Faculty of Medicine, Hebrew University of Jerusalem, Israel G.G. Nyquist Department of Otolaryngology and Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States A. Bebin Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel Y. LahavDepartment of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel Faculty of Medicine, Hebrew University of Jerusalem, Israel M. WarmanDepartment of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel Faculty of Medicine, Hebrew University of Jerusalem, Israel Journal Article 3404 10.4193/Rhin25.393 BACKGROUND: Biologic therapy has emerged as a key treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), particularly in refractory cases, but its effect on healthcare utilization is not well established. METHODOLOGY: We conducted a retrospective big-data analysis using the Clalit Health Services database, identifying all CRSwNP patients treated with dupilumab or mepolizumab following endoscopic sinus surgery (ESS) between 2010–2024. We assessed antibiotic and systemic steroid use, visits to clinics, emergency rooms (ER), hospitalizations, and repeat ESS before and after biologic initiation. RESULTS: Among 861 patients (54.2% on dupilumab, 45.8% on mepolizumab), 62% had asthma. Median therapy duration was 25 months. Mean follow-up was 130 ± 78 months before treatment and 43 ± 42 months after. Biologics significantly reduced antibiotic and systemic steroid use, as well as community clinic, hospitalization, and revision ESS rates. Serum eosinophils declined from 520 ± 440 to 430 ± 460 cells/μL. CONCLUSIONS: Post-ESS biologic therapy in CRSwNP patients is associated with reduced healthcare utilization and systemic medication use, highlighting its positive impact on disease burden and healthcare efficiency.