Are New Biologics a Game Changer for Treating Nasal Polyposis?

Which cytokines do the new crop of biologics target?

• Dupilumab (Dupixent, Sanofi Genzyme) is a monoclonal antibody that targets the alpha chain of the IL-4 receptor and inhibits the effects of IL-4 and IL-13, two cytokines involved in inflammation in chronic sinusitis with nasal polyposis.
• Mepolizumab (Nucala, GSK) is a humanized anti-IL-5 antibody that has also been shown to significantly reduce nasal polyps and improve smell, post-nasal drip, and nasal congestion.
• Omalizumab (Xolair, Novartis) is a fully humanized, anti-IgE monoclonal antibody that has also been shown to significantly reduce polyp size and improve symptoms in clinical trials (Allergy Clin Immunol Pract. 2016;4:565–572).

At this time, mepolizumab and omalizumab are not approved for treatment of nasal polyposis. Other biologics being studied for nasal polyp treatment include two other monoclonal antibodies, reslizumab (Cinqair, Teva) and benralizumab (Fasenra, AstraZeneca) (Am J Rhinol Allerg. 2019;33:203–211).