Chronic rhinosinusitis with and without nasal polyps: the state-of-the-art of current treatment strategies and future developments

Nappi E, Marzio V, Giombi F et al.  Front Allergy. 2025 Dec 15;6:1714577. doi: 10.3389/falgy.2025.1714577.

Abstract

Therapeutic evolution in primary chronic rhinosinusitis (CRS):
from symptomatic relief to targeted inflammatory modulation 

Over the past decade, chronic rhinosinusitis (CRS) management has undergone substantial transformation, shifting from conventional symptom-focused treatments to precision medicine strategies grounded on molecular insights. The introduction of biologic agents has significantly changed the therapeutic landscape for CRS with nasal polyps (CRSwNP), directly addressing key inflammatory pathways and leading to marked reductions in nasal polyp burden, overall disease impact, and corticosteroid use.

A strategic framework for digital and sustainable transformation in allergy care: An EAACI position paper

Feketea G, Paciência I, Chang YS et al. Pediatr Allergy Immunol. 2026 Jan;37(1):e70270. doi: 10.1111/pai.70270. 

Abstract

Background

Allergic diseases, particularly in children, are increasing worldwide and impose growing clinical, economic, and environmental burdens on healthcare systems. Conventional models of allergy care face limitations in early diagnosis, long-term disease monitoring, patient engagement, and sustainability, highlighting the need for innovative and scalable solutions.

Objectives

This position paper aims to propose a global framework for integrating digital health innovations with sustainable models of allergy and immunology care, with particular attention to pediatric and general allergy services.

Methods

The paper is formulated as an expert opinion–based position document informed by current scientific evidence on digital health applications and sustainable healthcare practices in allergy and immunology. Key domains were identified through literature review and consensus discussions, focusing on digital transformation, environmental sustainability, and international collaboration.

Results

The proposed roadmap highlights three strategic priorities: (1) leveraging digital health solutions—including mobile health, telemedicine, and artificial intelligence—to enhance early diagnosis, personalized treatment, and real-time disease monitoring; (2) embedding environmentally sustainable practices into routine allergy care to reduce healthcare-related carbon emissions; and (3) fostering international collaboration among clinicians, researchers, and policymakers to promote equitable access to digital allergy care across diverse healthcare systems.

Biologic Therapies: A Systematic Review of the Indications, Efficacy, Safety, and Outcomes in Ear, Nose, and Throat Diseases

Al Saloom Z, Alawainati M, Abdeen Z, et al. (January 07, 2026)  Cureus 18(1): e101059. doi:10.7759/cureus.101059

Abstract

Biologic therapies, such as omalizumab, mepolizumab, and dupilumab, are novel therapeutic agents that offer a targeted approach for managing chronic inflammatory and immune-mediated ear, nose, and throat (ENT) conditions. However, the indications, efficacy, and adverse events of these medications in various ENT disorders have not been studied before. Therefore, this systematic review was performed to evaluate their indications, clinical efficacy, and safety in ENT management. A systematic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across five major databases:

The molecular mechanism of the adverse effects of the biological and small molecular drugs in the therapy of inflammatory skin diseases - psoriasis and atopic dermatitis

Lemiesz P, Nowowiejska-Purpurowicz J, Flisiak I. Ann Med. 2026 Dec;58(1):2611461. doi: 10.1080/07853890.2025.2611461.

Abstract

The summary of pathogenesis and comparison between
psoriasis and atopic dermatitis.

Patients with the most common chronic inflammatory dermatoses, namely psoriasis and atopic dermatitis, gained access to state-of-the-art therapeutic options providing spectacular improvement of skin lesions. Although generally safe, biological agents and small molecular drugs have also side effects which may be mild and irrelevant to the therapy course, but sometimes, of a greater extent and influencing further therapeutic decisions. In this review, we summarize the molecular explanation for the most common adverse effects of drugs used in the treatment of psoriasis and atopic dermatitis. Biologics used in psoriasis predominantly target TNFα, IL-17, 23, while in AD inhibit IL-4,13,31. Janus kinase (JAK) inhibitors represent small-molecule therapies effective in both conditions, although more prominently in AD.

Five-Grass-Pollen Sublingual Immunotherapy Drops Are Efficacious and Well Tolerated in Adults: The RHAPSODY Phase III Trial

Didier A, Juhl RG, Dalgaard T et al. Allergy. 2025 Dec 24. doi: 10.1111/all.70191.

ABSTRACT

Background

Tablet formulations of allergen extracts are widely recommended over other formulations for the sublingual immunotherapy (SLIT) of respiratory allergies. However, with adequate clinical trial evidence, SLIT (liquid) drop formulations may be a relevant allergy treatment option.

Methods

Graphical Abstract

The RHAPSODY multinational, Phase III, parallel-group, double-blind, placebo-controlled, randomised clinical study of adults with moderate-to-severe, grass-pollen-induced allergic rhinoconjunctivitis (ARC) with or without asthma was conducted at 45 investigating centres in six European countries. Participants received 26 months of continuous treatment with active 5-grass-pollen SLIT drops or placebo. The primary efficacy endpoint was the average daily total combined score (TCS, comprising a symptom score and a rescue medication score) during the second peak grass pollen season (PGPS).

Results

Of the 445 randomised patients (mean ± standard deviation (range) age: 32.6 ± 9.9 (18–63); males: 55.1%), 389 completed the trial.

Baseline Monocyte Count Predicts Complete Response to Omalizumab in Chronic Spontaneous Urticaria: A Retrospective Analysis

Turhan İ D, Solak B (January 01, 2026) Cureus 18(1): e100556. doi:10.7759/cureus.100556

Abstract

Introduction: Chronic spontaneous urticaria (CSU) is a distressing skin condition characterized by wheals and angioedema. While omalizumab is an effective biologic therapy for antihistamine-refractory CSU, a subset of patients shows partial or no response. Identifying reliable biomarkers to predict treatment outcomes remains a significant clinical need. This study aimed to investigate the relationship between systemic inflammatory parameters, specifically monocyte counts, and the clinical response to omalizumab.

Methods: This retrospective study included 52 patients with CSU treated with omalizumab (300 mg/four weeks) for at least 12 weeks at a tertiary referral center. Patients were stratified into two groups based on their response at week 12: "Complete Response" (Urticaria Activity Score over seven days (UAS7) = 0) and "Non-Complete Response." Baseline and post-treatment complete blood count (CBC) parameters, C-reactive protein (CRP), and total IgE levels were analyzed. Binary logistic regression was performed to identify independent predictors of response.

Binary logistic regression analysis for independent
predictors of complete response to omalizumab

Results: Eleven patients (21.15%) achieved a complete response. The complete responder group exhibited significantly higher baseline median monocyte counts (0.68 vs. 0.40 K/µL, p = 0.001) and basophil counts (p = 0.032), but significantly lower baseline CRP levels (p = 0.003) compared to non-responders.

Rebound Pruritus and Urticaria Post-discontinuation of Chronic Cetirizine Use: A Case Report.

Seng J, Cai M, Oka P (December 27, 2025) Cureus 17(12): e100214. doi:10.7759/cureus.100214

Abstract

Timeline of events

Cetirizine is a common over-the-counter antihistamine used to treat allergic rhinitis, eczema, and urticaria. There have been increasing reports showing increased risk of rebound pruritus following discontinuation of long-term antihistamine use in the United States and the Netherlands. However, evidence on this condition and its management among Asian populations remains limited. We report the case of a Chinese male in his 50s with a background of hypertension, hyperlipidaemia, and chronic urticaria who had been regularly taking over-the-counter cetirizine for the past two years.

Abstracts of the 14th C1-inhibitor Deficiency and Angioedema Workshop

 Allergy Asthma Clin Immunol 21 (Suppl 2), 55 (2025). https://doi.org/10.1186/s13223-025-00992-1

Preface

We are pleased to welcome all participants to the 14th C1-inhibitor Deficiency & Angioedema Workshop.

The aim of the Workshop is to present new research findings related to rare bradykinin-mediated angioedema disorders. These include conditions caused by hereditary or acquired C1-inhibitor deficiency, as well as those with a hereditary background but normal C1-inhibitor levels. This year, a record number of abstracts will be presented over the four-day program, including 49 oral and 58 poster presentations. In addition to previously unpublished findings, five outstanding keynote lectures will also be delivered.

On the opening afternoon, Nobel Laureate Katalin Karikó will give a special lecture on the development of the mRNA vaccine, sharing all the insights gained from the long and persistent journey that led to the production of life-saving mRNA-based vaccines.