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Favorite

Late-Breaking Scientific Oral Presentation

Rhinology/Allergy

National Trends in Corticosteroid and Biologic Prescribing for Chronic Rhinosinusitis: A 10-Year Epic Cosmos Analysis

Monday, October 19, 2026

4:12 PM - 4:18 PM PT

Location: West Exhibit Hall A, Learning Zone 7

Co-Author(s)

AS

Alice R. Su, MD

Resident Physician
University of California Davis Health
Sacramento, CA, United States
Edward Bradley Strong, MD

Professor
Univ of California At Davis Med Ctr
Sacramento, CA, United States

Senior Author(s)

TS

Toby O. Steele, MD

Professor
University of California Davis
Sacramento, California, United States

Presenting Author(s)

Anuj U. Patel, MD

Resident Physician
University of California (Davis) Health System
Sacramento, CA, United States

Disclosure(s):

Anuj U. Patel, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Biologic therapies for chronic rhinosinusitis (CRS) have demonstrated steroid-sparing effects in clinical trials; however, it is unknown as to whether this translates to fewer oral corticosteroid prescriptions at the CRS population-level. This study evaluates national prescribing trends of systemic corticosteroids and biologics in CRS over the past decade.

Methods: An analysis of the Epic Cosmos database was performed from January 2016 through December 2025. Patients with CRS diagnoses were identified while patients with alternative major indications for corticosteroid or biologic therapy were excluded. Quarterly prescriptions for prednisone, methylprednisolone, dupilumab, mepolizumab, and omalizumab were quantified and normalized per 100 newly diagnosed CRS patients. Corticosteroid co-prescription among biologic-treated patients was additionally evaluated from 2019–2025.

Results: A total of 1,896,068 CRS patients met inclusion criteria. Biologic prescribing increased from 0.02 to 0.95 prescriptions per 100 CRS diagnoses between 2016 and 2025, representing a 3,820% increase. Despite this, systemic corticosteroid prescriptions increased from 13.4 to 23.2 prescriptions per 100 CRS diagnoses, a 73% increase. Among biologic-treated patients, corticosteroid co-prescription rates declined over time, including a decrease from 45% to 33% among dupilumab-treated patients.

Conclusions: Although biologic utilization for CRS increased dramatically over the past decade, systemic corticosteroid prescribing continued to rise nationally. Increased biologic adoption has not translated into reduced population-level corticosteroid utilization.