Biologika in der Behandlung der chronischen Rhinosinusitis mit Nasenpolypen – Aktueller Stand

Abstract

In 2006 to 2017, a number of randomized, double-blind, placebo-controlled trials on the use of monoclonal antibodies in chronic rhinosinusitis with nasal polyps were published. They were the first to demonstrate that these innovative therapies are in principle effective in the treatment of nasal polyps. The target proteins, interleukin (IL)-4, IL-5, and IL-13 as well as immunoglobulin (Ig) E had been identified as key proteins in previous basic studies. The studies are characterized by small numbers of cases, but have paved the way for phase 3 studies, which are currently underway and which could lead to the market introduction of the first drug with this indication as early as next year. They already provide some hints of the effects to be expected from biologics; however, phase 3 studies with more patients and a more homogeneous patient population will be crucial for indications, patient selection, and stop rules for each of these biologics. For those patients with severe polyposis whose disease could previously not be controlled by pharmacotherapy and/or surgery, there will undoubtedly be new therapeutic options that will put an end to the risks and shortcomings of previous therapies.