Table 5.

Summary of Targeted Biologics for Allergic Rhinitis

Biologic Agent	Target	Mechanism of Action	Key Clinical Findings	Other Characteristics	Reference Citations
Omalizumab	IgE	Binds to free IgE in serum, preventing its binding to the high-affinity receptor (FcεRI) on effector cells, thereby blocking the upstream allergic cascade and downregulating FcεRI expression	Significantly improved nasal and ocular symptoms, quality of life, and work efficiency in severe pollinosis patients inadequately controlled by standard therapy; Real-world studies support efficacy in SAR and PAR, especially for nasal congestion, with long-term safety and efficacy	Effective as pre-seasonal prophylactic treatment; The ratio of total IgE level at week 16 to baseline (≥2.0) may predict clinical response; Patients with more severe baseline symptoms show greater improvement; Reduces work productivity loss; Effective in chronic urticaria; Improved behavioral symptoms in an ASD child	150-161
Dupilumab	IL-4/IL-13	Specifically binds to IL-4Rα, simultaneously blocking signaling of both IL-4 and IL-13	Significantly "normalized" the disease-associated gene expression profile in nasal tissue of AR patients; Reduced serum levels of type 2 inflammatory biomarkers (total IgE, TARC, eosinophils); Shows efficacy in comorbidities like Asthma with AR, CRSwNP with AR, AD with AR	Combined with SCIT improves SCIT tolerability, allows more patients to reach maintenance dose, and reduces epinephrine use; In severe refractory AD, combination with SCIT induced favorable immunological changes	162-173
Tezepelumab	TSLP	Specifically binds and blocks TSLP, broadly inhibiting downstream inflammatory pathways	Significantly and sustainably reduced the annualized asthma exacerbation rate (AAER), improved lung function and quality of life in severe asthma patients, irrespective of baseline Type 2 biomarker levels, with good long-term safety; Effective in subgroups including patients with CRSwNP, PAO, NSAID sensitivity, and Japanese patients	Combination with SCIT enhanced efficacy and showed partially sustained clinical benefit one year after discontinuation, suggesting potential for inducing long-term immune tolerance	174, 175, 177-183