Nasal polyps treatment have shown great advances recently, and many more treatments are on the horizon. Nasal polyps are used to describe chronic rhinosinusitis associated with the formation of nasal polyps. Nasal polyps affect 2-4% of adults globally. About 50% of patients have existing allergies.
Nasal polyps are semitranslucent, pale grey, grape-like, benign inflammatory lesions of asymmetric size in the sinuses or nasal cavity. The inflammatory profile of patients with nasal polyps varies. Many different inflammatory cytokines play a role in their formation.
In the past, nasal polyps treatment consisted of nasal saline irrigation and/or intranasal steroids. Systemic steroids and/or antibiotics were second line options. Antibiotics may be of limited efficacy in nasal polyps.
Surgery is indicated when nonsurgical treatments fail. However, up to 80% of patients who undergo endoscopic sinus surgery (ESS) experience a return of the symptoms of nasal polyps within 1 year.
Monoclonal antibody therapy represents a novel treatment option for patients with severe nasal polyps.
Dupilumab for Nasal Polyps is a therapy that inhibits IL-4 and IL-13 mediated signaling, significantly improving nasal polyp size and nasal congestion and obstruction. It also reduced the need for steroids and surgery.
Xolair for Nasal Polyps is an anti-IgE antibody therapy that also has demonstrated clinical efficacy and safety in phase 3 trials.
Two monoclonal antibodies targeting the IL-5 pathway are being investigated, mepolizumab and benralizumab. Both of them are showing positive data in phase 3 trials so far.
In terms of nasal polyps treatment, the nasal polyps are driven by chronic inflammation, resluting in impairment of the sinonasal epithelial battier, increased exposure to allergic or inflammatory triggers/superantigens and dysregulation of the immune response. Multiple different medications may be used to treat nasal polyps depending on which pathway is contributing to its cause.