Steroids, Surgery, and Biologics, Oh My! Following the Path to Selecting Appropriate Treatments for Individual Patients with CRSwNP




Provided by Integrity Continuing Education, Inc..


This activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc and Sanofi Genzyme.


Until recently the only treatment choices for patients with CRSwNP, a chronic inflammatory condition of the sinonasal cavities, included saline irrigation for symptomatic relief, local or oral corticosteroids to keep inflammation under control, and polypectomy through endoscopic sinus surgery. Of the upper inflammatory disorders, perhaps the most recalcitrant and refractory is CRSwNP. Nasal polyposis is typically present in patients with the highest levels of disease severity, and endoscopic surgery to remove polyps is not the cure one might presume. Nearly 80% of patients who undergo polypectomy experience polyp recurrence within two years and >35% eventually opt for a second surgery.

Novel biologics that were successful in controlling some forms of severe asthma were put into clinical trials to evaluate their impact on CRSwNP. Availability of biologics for CRSwNP gives clinicians treatment options beyond steroids and surgery for their CRSwNP patients who are struggling to breathe freely. However, it also confronts them with new and different decisions. What criteria should be used in choosing which CRSwNP patients should be prescribed a biologic? Which one should be tried and why? What did clinical trials reveal about their efficacy and safety in CRSwNP? How do I educate and prepare patients for treatment with a biologic? This program is designed to address these and other questions related to the treatment of patients with CRSwNP.


Cecelia C. Damask, DO
Assistant Clinical Professor​
Department of Otolaryngology​
University of Central Florida​
Orlando, Florida


Christine B. Franzese, MD
Professor, Director of Allergy​
Department of Otolaryngology​
University of Missouri – Columbia​
Columbia, Missouri


Robert M. Naclerio, MD
Otolaryngology-Head and Neck Surgery​
Johns Hopkins University​
Baltimore, Maryland


Release date: November 19, 2021
Expiration date: November 19, 2022
Estimated time to complete activity: 75 minutes



This educational activity has been designed to meet the needs of otolaryngologists, otolaryngic allergists, and nurse practitioners and physician assistants in otolaryngology specialty practice


Upon completion of this educational activity, participants should be able to:

  • Identify the phenotypes and endotypes of chronic rhinosinusitis with and without nasal polyps based on what is understood thus far about immunologic pathophysiology and its impact on disease burden
  • Summarize the inflammatory targets of biologic treatments for CRSwNP and their efficacy and safety profiles reported in clinical trials
  • Implement appropriate selection criteria for patients with CRSwNP who might benefit from treatment with targeted biologics over steroids or surgery

There are no fees for participating and receiving CME credit for this activity. During the period of November 19, 2021 and November 19, 2022 participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.




Physician Continuing Education


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Integrity Continuing Education, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


Integrity Continuing Education, Inc. designates this enduring activity for a maximum of 1.25 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


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Integrity Continuing Education, Inc. requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education, Inc. for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. All relevant financial relationships have been mitigated.

The following faculty/planners reported the financial relationships or relationships to products or devices they have with ineligible companies related to the content of these CME activities:

Cecelia C. Damask, DO
Advisory Board: AstraZeneca, Genentech/Novartis, GlaxoSmithKline, Optinose, Regeneron/Sanofi ​
Consultant: Audigy Medical​
Contracted Clinical Research: AstraZeneca, GlaxoSmithKline, Optinose, Regeneron/Sanofi ​
Speakers Bureau: ALK, AstraZeneca, Genentech/Novartis, GlaxoSmithKline, Optinose, Regeneron/Sanofi​

Christine B. Franzese, MD
Advisory Board: GlaxoSmithKline, Sanofi ​
Research Funding: ALK, Bellus, GlaxoSmithKline, Merck, Novartis, Regeneron, Sanofi, Shiniogi ​
Speakers Bureau: ALK, Genentech, GlaxoSmithKline, Novartis, Regeneron, Sanofi​

Robert M. Naclerio, MD
Advisory Board: AstraZeneca, Celgene, GlaxoSmithKline, Lyra Therapeutics, Regeneron, Sanofi

The Integrity Continuing Education, Inc. planners and managers have nothing to disclose.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc. does not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


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