Provided by Integrity Continuing Education, Inc.
Supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc. and Sanofi Genzyme.
Until recently the only treatment choices for patients with Chronic Rhinosinusitis with Nasal Polyps (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. But as the pathophysiologic mechanisms of asthma began to be unraveled, a common endotype of T-helper cell type 2 (TH2) inflammation began to emerge, showing shared molecular mechanisms between severe asthma and uncontrolled CRS. Researchers realized that the monoclonal antibody treatments developed to treat severe asthma could also be an effective treatment option for CRSwNP. These biologic agents target common TH2 inflammatory drivers that are endotypic of both upper and lower respiratory atopic disorders; specifically, interleukin (IL) cytokines IL-4, IL-5, and IL-13, and circulating or local immunoglobulin E (IgE).
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. This program has been designed to address questions surrounding the use of biologics when treating patients with CRSwNP.
Michael S. Blaiss, MD, FACAAI
Executive Medical Director
American College of Allergy, Asthma, & Immunology
Arlington Heights, Illinois
This educational activity has been designed to meet the needs of allergists, immunologists, and specialty nurse practitioners (NPs)/physician assistants (PAs).
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Michael S. Blaiss, MD, FACAAI
Consulting Fees: ALK-Abello Inc., GlaxoSmithKline, Merck, Perrigo, Pfizer, Regeneron, Sanofi, TerSera
Speakers’ Bureaus: ALK-Abello Inc., Merck, Regeneron, Sanofi
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