With so many options available, the best nasal polyps treatment can be hard to pick. Chronic rhinosinusitis with nasal polyps is an inflammatory disease of the upper airways characterized by polyp growth in the nasal passages. It causes severe congestion, discharge and difficulty with smell. The best treatment option is unclear.
A study published in the Journal of Allergy and Clinical Immunology titled “Comparative efficacy and safety of monoclonal antibodies and aspirin desensitization for chronic rhinosinusitis with nasal polyposis: A systematic review and network meta-analysis” examined which treatment worked best.
7 Biologics were examined along with Aspirin Desensitization. The criteria used were:
- Health related quality of life
- Nasal Polyp Size
- Radiologic Severity
- Rescue Oral corticosteroid use
- Rescue Surgery
- Any Adverse Events
Key Findings of the study showed:
- Dupilumab consistently and uniquely ranked among the most beneficial treatments for 7 out of 7 patients outcomes.
- Other treatments, such as Xolair, Nucala and Fasenra and aspirin therapy all greatly improved 1 or 2 key outcomes.
- Biologics have an improved safety profile compared to aspirin desensitization.
The other treatments not listed above were Reslizumab, AK001 and Etokimab. Those did not show positive outcomes in the criteria above.
To date only Dupixent, Nucala and Xolair are approved for nasal polyps.
Mepolizumab (Nucala) for Nasal Polyps
We have extensively written about nasal polyps in other blog posts:
Fasenra for Nasal Polyps, a new treatment option
Xolair, Dupixent or Nucala for Nasal Polyps?
Nasal Polyps Treatment; Past, Present and Future
Every patient is different, and there is not a once size fits all approach. But based on this study, it suggests that Dupixent is the best nasal polyps treatment amongst all the current biologics. Surgery is also another option as well for patients who have extensive disease. That option should be discussed as well for patients.