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Review
. 2020 May;8(5):1522-1531.
doi: 10.1016/j.jaip.2020.01.031. Epub 2020 Jan 28.

Current and Future Treatments of Rhinitis and Sinusitis

Gayatri B Patel  1 , Robert C Kern  2 , Jonathan A Bernstein  3 , Park Hae-Sim  4 , Anju T Peters  5
Affiliations
Review

Current and Future Treatments of Rhinitis and Sinusitis

Gayatri B Patel et al. J Allergy Clin Immunol Pract. 2020 May.

Abstract

Advances in understanding the pathogenic mechanisms of both rhinitis and chronic rhinosinusitis have resulted in new treatment options, especially for chronic rhinosinusitis. A review of relevant medical and surgical clinical studies shows that intranasal corticosteroids, antihistamines, and allergen immunotherapy continue to be the best treatments for chronic rhinitis. Dupilumab is the first biologic approved for chronic rhinosinusitis with polyps. Omalizumab, mepolizumab, and benralizumab may have a future role in the treatment of chronic rhinosinusitis. Novel corticosteroid delivery devices such as an exhalation delivery system for fluticasone and bioabsorbable sinus implants provide enhanced and localized distribution of corticosteroids. Surgical management tailored to the underlying disease process improves clinical outcomes in chronic rhinosinusitis with or without nasal polyposis. Advances in the understanding of the heterogeneous nature of rhinitis and rhinosinusitis have resulted in more precise treatments. Improving the understanding of different endotypes should provide better knowledge to determine appropriate current and new therapies to treat these diseases.

Keywords: Bioabsorbable sinus implant; Chronic rhinitis; Chronic rhinosinusitis; Dupilumab; EDS-FLU; Mepolizumab; Nasal polyposis; Omalizumab; Sinus surgery.

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Conflict of interest statement

Potential conflict of interest: A. T. Peters is a consultant for Sanofi-Regeneron; consultant at and receives research support from AstraZeneca; receives research support from OptiNose. R.C. Kern is a consultant for Sanofi-Regeneron. Remaining authors have no potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Inflammatory type 2 pathway is the principle mechanism involved in chronic rhinosinusitis with nasal polyposis (CRSwNP) pathogenesis and targets of pharmacotherapy. Adapted from “Pathogenesis of nasal polyposis” by Hulse et al. 2015. Clin Exp Allergy 45(2), 341. Illustration courtesy of Dr. Robert Schleimer.
See this image and copyright information in PMC

Comment in

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