Chronic Rhinosinusitis with Nasal Polyps: Targeting IgE with Anti-IgE Omalizumab Therapy

Drug Des Devel Ther. 2020 Dec 10:14:5483-5494. doi: 10.2147/DDDT.S226575. eCollection 2020.


Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex, clinically heterogeneous and persistent inflammatory disorder of the upper airway. Detailed mechanistic insights into disease pathogenesis are lacking, but it is now accepted that local tissue IgE driven T2-high inflammatory pathways are critical to disease. The recent CRSwNP Phase 3 POLYP1 and POLYP2 replicate studies of blocking IgE with omalizumab confirmed rapid improvements in all clinical parameters of sinonasal disease, confirming a pivotal role for IgE driven inflammatory pathways in CRSwNP. This review summarises the biology of IgE in relation to CRSwNP. Insight into how IgE may drive CRSwNP is evaluated in the context of clinical improvements seen with omalizumab. The need for further studies using a broader patient and biomarker specific groups to aid more precise drug-patient selection alongside more detailed mechanistic studies of omalizumab in CRSwNP is highlighted.

Keywords: IgE; nasal polyps; omalizumab; rhinosinusitis.

Publication types

  • Review

MeSH terms

  • Anti-Allergic Agents / immunology
  • Anti-Allergic Agents / pharmacology*
  • Chronic Disease
  • Humans
  • Immunoglobulin E / immunology
  • Nasal Polyps / drug therapy*
  • Nasal Polyps / immunology
  • Omalizumab / immunology
  • Omalizumab / pharmacology*
  • Rhinitis / drug therapy*
  • Rhinitis / immunology
  • Sinusitis / drug therapy*
  • Sinusitis / immunology


  • Anti-Allergic Agents
  • Omalizumab
  • Immunoglobulin E

Grants and funding

This manuscript was not funded.