목적: Recent advancements have identified biologic therapies as potent options for treating chronic rhinosinusitis (CRS). Ensuring patient adherence is key to achieving the best results. However, there is a paucity of research examining the factors influencing adherence to biologic therapies. This study focuses on determining the variables impacting adherence to dupilumab and omalizumab in individuals with CRS. 방법:We evaluated the medical records of CRS patients, with or without nasal polyps, who were prescribed monthly treatments of dupilumab or omalizumab from 2021 to 2023 at four affiliated medical institutions of The Catholic University of Korea. Exclusion criteria included individuals below 18 years and those using biologics for non-CRS conditions. Patients who received injections at intervals of less than 2 months continuously for at least 6 months were classified into Group A (adherent), while others were placed in Group B (non-adherent). We compared clinical characteristics across groups and adherence rates between dupilumab and omalizumab users. 결과:The study incorporated 45 patients (26 dupilumab users, 18 omalizumab users, and 1 both user). Adherent patients showed significantly higher olfactory identification test scores (Dupilumab users: 63.2 vs. 37.0, P = 0.043; Omalizumab users: 37.5 vs. 20.8, P = 0.044; Total study population: 59.7 vs. 30.5, P = 0.002). Lower adherence was observed in patients initiating treatment in summer (P = 0.053, 0.529, and 0.017 for dupilumab users, omalizumab users, and total study population, respectively). No marked difference was noted in body mass index, asthma presence, initial nasal symptoms, immunoglobulin E levels, blood eosinophils, or Lund-Mackay CT scores between the groups. Treatment initiation peaked in spring (37.8%), while discontinuations were highest in winter, in the total study population (44.4%), as well as in dupilumab users (46.2%) and omalizumab users (44.4%). Furthermore, winter had the lowest rates of injection administration in the total study population (19.4%), in dupilumab users (19.9%), and in omalizumab users (15.7%), respectively. There was no significant adherence discrepancy between dupilumab and omalizumab users. 결론:Higher olfactory function test scores in adherent patients indicates a prolonged recovery to normal smell function in anosmic patients compared to hyposmic ones, impacting their adherence. Seasonal variations in nasal symptoms and hospital accessibility could contribute to seasonal differences in adherence. Further exploration into biologic therapy adherence is critical for optimizing CRS treatment efficacy.