Uncharted Waters: Challenges in the Era of Biologic Therapies for Nasal Polyposis

J Allergy Clin Immunol Pract. 2019 Jan;7(1):68-70. doi: 10.1016/j.jaip.2018.07.017. Epub 2018 Sep 11.

Abstract

Several new, promising, targeted therapies for nasal polyposis are being tested in large-scale clinical trials. These agents target pathways thought to be involved in the disease, including IgE, IL-5, IL-4/IL-13, and others. Designing these trials poses significant challenges: who and when to enroll is not completely clear, optimal dosing is not known, outcome measures are insufficiently robust, there are no validated biomarkers, trial regimens may not comport with how clinicians might use these drugs once approved, and cost-benefit ratios have not been assessed. Thus, there is a need to consider such questions, as trials of these novel treatments continue and these biologics become available. Despite these uncertainties about trial design, there remains a great deal of excitement in the field as we approach the dawn of a new era of therapeutic options for nasal polyposis. In this rostrum, we enumerate these issues and call for a conference that will allow stakeholders in the field to confront them as we enter this new era of opportunity to advance the treatment of nasal polyposis.

Keywords: Nasal polyposis; biologics; clinical trials.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antibodies, Blocking / therapeutic use*
  • Biological Products / therapeutic use*
  • Biological Therapy / methods*
  • Clinical Trials as Topic
  • Cost-Benefit Analysis
  • Cytokines / immunology*
  • Humans
  • Immunoglobulin E / immunology*
  • Immunologic Factors / therapeutic use*
  • Nasal Polyps / economics
  • Nasal Polyps / therapy*
  • Outcome Assessment, Health Care
  • Patient Selection

Substances

  • Antibodies, Blocking
  • Biological Products
  • Cytokines
  • Immunologic Factors
  • Immunoglobulin E