Biologic Agents for the Treatment of Chronic Rhinosinusitis With Nasal Polyps

Am J Rhinol Allergy. 2019 Mar;33(2):203-211. doi: 10.1177/1945892418814768. Epub 2018 Dec 27.

Abstract

Background: Chronic rhinosinusitis with nasal polyposis is a complex inflammatory disorder, which is often recalcitrant to medical and surgical management. Recently, biologic agents have been studied as an adjunct treatment for this patient population.

Objective: The purpose of this study is to examine the role of biologic agents for chronic rhinosinusitis patients by reviewing literature and clinical trials.

Methods: A comprehensive review of literature and clinical trials-both recently completed and ongoing-was undertaken to examine up-to-date evidence of current biologic therapy and its role in chronic rhinosinusitis patients-including anti-IgE, anti-IL-4, anti-IL-5, anti-IL-13, and GATA-3 DNAzyme.

Results: Specific biologic agents discussed include omalizumab, reslizumab, mepolizumab, benralizumab, dupilumab, and Hgd40/SB010. Risks, side effects, and administration information are also reviewed. An algorithm for the use of biologics in patients with chronic rhinosinusitis with nasal polyposis is proposed.

Conclusion: These treatments have promising results and may prove to be an important adjunct for patients with recalcitrant sinus disease.

Keywords: GATA-3 DNAzyme; Hgd40; SB010; anti-IL-13; anti-IL-4; anti-IL-5; anti-IgE; benralizumab; biologic agents; chronic rhinosinusitis; dupilumab; mepolizumab; nasal polyposis; omalizumab; reslizumab.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / therapeutic use
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Biological Therapy*
  • Chronic Disease
  • DNA, Catalytic / adverse effects
  • DNA, Catalytic / therapeutic use*
  • Humans
  • Nasal Polyps / complications
  • Nasal Polyps / therapy*
  • Rhinitis / complications
  • Rhinitis / therapy*
  • Sinusitis / complications
  • Sinusitis / therapy*

Substances

  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal
  • DNA, Catalytic