The therapeutic response of the more severe forms of chronic rhinosinusitis with nasal polyposis (CRSwNP) to biologics has not been fully evaluated, and therefore, anti-inflammatory therapy with oral steroids may still be required. Long-term treatment with systemic steroids can lead to significant comorbidity,1 yet steroid-sparing agents (SSAs) are rarely considered in the context of CRSwNP.2 Mycophenolate mofetil (MMF) is a potent immunosuppressant. Mycophenolate mofetil selectively inhibits T- and B-cell activation, proliferation, and effector function leading to an immunosuppressive state.3,4 Given the key role for T and B cells in CRSwNP in the drive and maintenance of T2 inflammation and immunoglobulin E production, we hypothesized that MMF should attenuate inflammation and allow reduction of the maintenance dose of systemic steroids.
Kariyawasam HH, Leandro M, Dziadzio M, Robinson DS, Lund VJ, Gane SB. Chronic Rhinosinusitis With Nasal Polyps In Patients With Aspirin Sensitivity—Mycophenolate Mofetil as an Effective Steroid-Sparing Agent. JAMA Otolaryngol Head Neck Surg. 2021;147(2):214–215. doi:10.1001/jamaoto.2020.3401
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