The role of omalizumab in the treatment of chronic rhinosinusitis with nasal polyposis

ABSTRACT

Introduction: Chronic rhinosinusitis with nasal polyposis (CRSwNP) poses a significant healthcare challenge, with diminished quality of life for patients and high costs and resource utilization for disease management. The understanding of CRSwNP pathophysiology has progressed with identification of various inflammatory biomarkers and subsequent development of monoclonal antibodies that target the underlying mechanisms of inflammation.

Areas covered: Omalizumab is a biologic agent for CRSwNP treatment that targets immunoglobulin (Ig)-E. The US FDA has approved the use of omalizumab as an add-on biologic therapy for nasal polyposis in December 2020. Two Phase III clinical trials, POLYP 1 and POLYP 2, have shown that omalizumab improves both subjective patient-reported outcomes and objective physician-evaluated metrics for CRSwNP. Ongoing studies are still exploring the efficacy, safety, and cost-effectiveness of biologics for CRSwNP.

Expert opinion: Biologics will continue develop as a viable management option for CRSwNP. Omalizumab is regarded as a promising addition to current treatment strategies for refractory disease.

KEYWORDS:

• Chronic rhinosinusitis
• nasal polyposis
• biologics
• omalizumab
• IgE
• monoclonal antibodies

Article highlights

• Omalizumab is a recently FDA-approved biologic approved for use in CRSwNP

• Omalizumab is a monoclonal antibiotic which targets free IgE to downregulate the Th2 inflammation pathway

• Omalizumab has shown significant improvement in disease severity in both Phase II and Phase III studies

• Generally, most participants tolerated omalizumab well with only minor adverse effects

• There is great need for cost-effective analyses for omalizumab and other biologics

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper is not funded.