The Grapevine

Eczema Drug Dupilumab May Help Treat Nasal Polyps In People With Chronic Sinus Infections

Sinus Infection
A drug that has demonstrated clinical efficacy for asthma and eczema may be able to improve nasal polyps in patients with sinus infections, according to a recent study. Pixabay

Previous studies have shown that the medication dupilumab has clinical efficacy in treating asthma and atopic dermatitis, or eczema. A new study, published this month in JAMA, has found that the drug may also be effective at treating nasal polyps in people suffering from chronic sinusitis.

Chronic sinusitus is a common illness which occurs when the tissue lining the sinuses becomes inflamed or swollen and fluid builds up, making it hard to breathe through the nose for more than 12 weeks. One of the risk factors for this condition is nasal polyps — common, non-cancerous growths that originate in the sinuses and obstruct the sinus and nasal passages. The nasal polyps themselves aren’t usually a cause for concern, but larger polyps can make sinuses more prone to infection by blocking normal drainage. Medications, such as intranasal corticosteroids, are used to treat the polyps and relieve symptoms of chronic sinusitis, including persistent stuffiness, postnasal drip and a decreased sense of smell.

“In patients in whom polyps and symptoms persist despite medical treatment, surgical excision is considered,” researchers wrote. “However, disease recurrence after surgery approaches 50 percent in patients with tissue eosinophilia, [a condition in which tissue reveals higher than normal levels of disease-fighting white blood cells at a site of infection or inflammation], and resolution of symptoms, including sense of smell loss, is often incomplete.”

Researchers collected and analyzed data from 60 patients with chronic sinusitis and nasal polyposis who were not responsive to intranasal corticosteroids — the only approved treatment for nasal polyps. The study participants were randomly assigned to take dupilumab or placebo plus mometasone furoate nasal spray for 16 weeks.

They found that dupilumab treatment was associated with significant improvements in both quality of life and major symptoms, such as subjective sense of smell, nasal obstruction or congestion, and nocturnal awakenings. The study also suggests this treatment could delay or reduce surgical intervention among patients whose symptoms persist despite treatment.

“Surgery is recommended as the next treatment option for patients who experience medical therapy failure; however, a substantial proportion of patients experience postsurgical recurrence and require additional surgery,” researchers wrote. “Although this trial was not designed to determine if dupilumab could delay or reduce surgical intervention, 58 percent of the study population had undergone prior surgery for nasal polyps, suggesting a potential role for dupilumab in this patient population.”

More research is needed to assess longer treatment duration and to investigate the potential use of dupilumab as adjunct therapy or in direct comparison with other medications or surgery.

Source: Bachert C, Mannent L, Naclerio R, et al. Effect of Subcutaneous Dupilumab on Nasal Polyp Burden in Patients With Chronic Sinusitis and Nasal Polyposis. JAMA . 2016.

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