Achieving dual remission requires a biomarker-guided hierarchy. Dupilumab demonstrates superior efficacy in the 'sinonasal-dominant' phenotype, particularly for olfactory restoration, while anti-IL-5 agents are preferable for the 'exacerbation-dominant' eosinophilic phenotype. Emerging data from the WAYPOINT trial suggests tezepelumab (anti-TSLP) as a potent option for broad epithelial blockade. We advocate moving beyond isolated disease control toward a stratified 'United Airway' remission target guided by fractional exhaled nitric oxide, blood eosinophils, and immunoglobulin E levels.
Lombardi et al. (Tue,) studied this question.