Anti-IgE therapy in chronic rhinosinusitis with nasal polyps
- PMID: 39551440
- PMCID: PMC12369497
- DOI: 10.1016/j.jaci.2024.11.011
Anti-IgE therapy in chronic rhinosinusitis with nasal polyps
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition characterized by type 2 (T2) immune responses with significant impacts on quality of life and health care costs. Local IgE production in nasal polyp tissue plays a key role in the T2 inflammatory cascade. Omalizumab, an anti-IgE monoclonal antibody, is an effective treatment for some patients with CRSwNP regardless of the patient's allergic status. Clinical trials, including the pivotal POLYP 1 and POLYP 2 studies, demonstrated omalizumab's efficacy in reducing nasal polyp size, improving symptom scores, and enhancing quality of life, particularly in patients with comorbid asthma and aspirin-exacerbated respiratory disease. As we summarize in this review, omalizumab's effect appears to involve the reduction in local IgE and T2 inflammation; however, this remains poorly understood. Notably, omalizumab's effectiveness appears to be partially sustained after long-term therapy, though symptoms and inflammation begin to return at discontinuation. Ongoing research is needed to determine the optimal duration of therapy and potential for biologics to modify the disease course. Additionally, further studies are needed to identify biomarkers to predict treatment response and to compare omalizumab with other biologics such as dupilumab in head-to-head trials. Omalizumab is one of the key T2-targeted therapeutic options for CRSwNP, with sustained effectiveness and strong safety profile.
Keywords: Anti-IgE; CRSwNP; chronic rhinosinusitis; nasal polyps; omalizumab.
Copyright © 2024 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
Disclosure statement Supported by the Chronic Rhinosinusitis Integrative Studies Program (NIH P01AI145818) and the Ernest Bazley Foundation. Disclosure of potential conflict of interest: A. T. Peters reports research support from AstraZeneca and Sanofi-Regeneron; and consultant for AstraZeneca, Sanofi-Regeneron, GSK, and Eli Lilly. G. B. Patel reports research support from Sanofi-Regeneron. K. D. Chhiba declares no relevant conflicts of interest.
Figures
Similar articles
-
The Efficacy of Omalizumab in Patients with Chronic Rhinosinusitis with Nasal Polyps and Comorbid Severe Allergic Asthma.Iran J Allergy Asthma Immunol. 2024 May 27;23(3):245-256. doi: 10.18502/ijaai.v23i3.15635. Iran J Allergy Asthma Immunol. 2024. PMID: 39422385
-
Omalizumab Efficacy in Chronic Rhinosinusitis Patients with Recurrent Nasal Polyps: An open-label, single-center, randomized, controlled study.Ann Otol Rhinol Laryngol. 2025 Sep;134(9):692-702. doi: 10.1177/00034894251344426. Epub 2025 May 28. Ann Otol Rhinol Laryngol. 2025. PMID: 40437843 Clinical Trial.
-
Systemic and topical antibiotics for chronic rhinosinusitis.Cochrane Database Syst Rev. 2016 Apr 26;4(4):CD011994. doi: 10.1002/14651858.CD011994.pub2. Cochrane Database Syst Rev. 2016. PMID: 27113482 Free PMC article.
-
Short-course oral steroids alone for chronic rhinosinusitis.Cochrane Database Syst Rev. 2016 Apr 26;4(4):CD011991. doi: 10.1002/14651858.CD011991.pub2. Cochrane Database Syst Rev. 2016. PMID: 27113367 Free PMC article.
-
Short-course oral steroids as an adjunct therapy for chronic rhinosinusitis.Cochrane Database Syst Rev. 2016 Apr 26;4(4):CD011992. doi: 10.1002/14651858.CD011992.pub2. Cochrane Database Syst Rev. 2016. PMID: 27115214 Free PMC article.
Cited by
-
LncRNA NEAT1 promotes epithelial-mesenchymal transition in nasal polyp cells via the miR-199-3p/PAK4 axis.Front Immunol. 2025 Jun 30;16:1613179. doi: 10.3389/fimmu.2025.1613179. eCollection 2025. Front Immunol. 2025. PMID: 40661947 Free PMC article.
-
Atractylenolide I alleviates the experimental allergic response in mice by suppressing TLR4/NF-kB/NLRP3 signalling.Open Life Sci. 2025 Aug 8;20(1):20251143. doi: 10.1515/biol-2025-1143. eCollection 2025. Open Life Sci. 2025. PMID: 40822971 Free PMC article.
References
-
- Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 2020; 58:1–464. - PubMed
-
- Dietz de Loos D, Lourijsen ES, Wildeman MAM, Freling NJM, Wolvers MDJ, Reitsma S, et al. Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology. J Allergy Clin Immunol 2019; 143:1207–14. - PubMed
-
- Hedman J, Kaprio J, Poussa T, Nieminen MM. Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 1999; 28:717–22. - PubMed
-
- Johansson L, Akerlund A, Holmberg K, Melen I, Bende M. Prevalence of nasal polyps in adults: the Skovde population-based study. Ann Otol Rhinol Laryngol 2003; 112:625–9. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials