![]() Biologics like dupilumab have already been approved for other indications, such as asthma and eczema. Each targets a different inflammatory trigger (see “Biologics: Inflammatory Targets,” below). Other biologics are being studied in clinical trials for treatment of nasal polyps, including omalizumab (Xolair, Novartis) and mepolizumab (Nucala, GSK). It also reduces the need for nasal polyp surgery and oral steroids.” In the announcement of the drug’s approval for this indication, Sally Seymour, MD, director of the division of pulmonary, allergy and rheumatology products in the FDA’s Center for Drug Evaluation and Research, said that dupilumab “provides an important treatment option for patients whose nasal polyps are not adequately controlled with intranasal steroids. Food and Drug Administration (FDA) to treat adults with nasal polyps accompanied by chronic rhinosinusitis. In June 2019, dupilumab (Dupixent, Sanofi Genzyme) was approved by the U.S. Most patients experience significant symptom relief with complete surgical polypectomy followed by topical corticosteroid irrigation, they say. They may work well in some patients to treat the symptoms of nasal polyps, but high cost and the need for regular injections for an indefinite period of time are two major concerns among otolaryngologists. Explore This Issue November 2019īiologics target and suppress specific drivers of inflammation in the immune system. But with endoscopic sinus surgery and new advances in medication, symptoms can be controlled better. Unfortunately at this time, there is no cure for chronic rhinosinusitis with nasal polyps. Surgery may be necessary for up to half of patients with nasal polyps. That allows medications to be adjusted as needed to control the polyps more effectively and potentially decrease symptoms. Once people are aware that they are predisposed to developing nasal polyps, they can be monitored regularly, and polyps often can be detected when they still are small. Polyps return in months or years for about half of patients. Most patients with chronic rhinosinusitis and nasal polyps need to keep using nasal medications and rinses after surgery.Īfter nasal polyps are removed, they have a tendency to come back. Then the surgeon uses tiny instruments to remove the polyps.ĭuring the surgery, the surgeon also will enlarge the openings leading from the sinuses to the nasal passages to help sinus rinses and medications reach the sinus cavities. During this procedure, a surgeon inserts an endoscope - a small tube with a lighted magnifying lens and camera - through the nostrils to see the sinuses. The type of surgery used to remove nasal polyps is called endoscopic sinus surgery. If medications don't shrink polyps to the point that they no longer cause symptoms, then surgery to remove them may be necessary. Early data shows that polyps and symptoms return once the medication is stopped. At this time, however, it is not known how long people with polyps need to be on this medication to control their polyps. It's been shown to decrease polyp size, and control chronic nasal and sinus inflammation. The medication, dupilumab, is given by injection every two weeks. There's also a new treatment option available for nasal polyps that was approved by the Food and Drug Administration in June. Treating an underlying condition, such as asthma or allergies, that may be associated with the chronic inflammation triggering polyp development can help control symptoms, as well. If that isn't enough, an oral corticosteroid, such as prednisone, may be recommended. The first line of treatment typically is a corticosteroid nasal spray to reduce swelling and irritation, along with nasal saline rinses. When polyps cause symptoms, treatment usually starts with medication to shrink them. Some research suggests that people who develop polyps have different immune system responses and different chemical markers in their mucous membranes than those who don't develop them. People who have allergies or asthma, and those who have airway reactions to aspirin or ibuprofen, tend to be at higher risk for developing nasal polyps. It's not clear what triggers the sinus inflammation that leads to the formation of nasal polyps.
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