Chronic rhinosinusitis with polyps (CRSwP) remains a challenging condition to treat. Patients vary substantially in their responses to existing therapies. Some patients require surgery with minimal postoperative medical management, while others require more extensive medical therapy with long-term use of topical and short-course “rescue” oral steroids. Some patients have refractory disease despite aggressive surgical and medical therapies. A recent systematic review1 of the best evidence regarding medical treatments for CRSwP identified only topical steroids, saline irrigations, and systemic steroids as having American Heart Association A-I level evidence. These medications, however, have no specific targets in the inflammatory pathways of CRSwP.
Schneider JS. Subcutaneous Dupilumab and Mometasone Furoate Nasal Spray for Chronic Rhinosinusitis With Polyps. JAMA Otolaryngol Head Neck Surg. 2016;142(7):698-699. doi:10.1001/jamaoto.2016.0678