Utilization of Corticosteroid Delivery Systems for Treatment of Nasal Polyposis - Episode 17

Emerging Treatment Options for Nasal Polyposis

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A multidisciplinary panel reviews emerging treatment options for nasal polyposis, including EDS-FLU, Tezepelumab, and Rimegepant.

Anju Peters, MD: What are you guys most excited about in terms of new medication options for patients, nasal polyps, new mechanism of actions, or any new ongoing trials for with polyps, but also for without polyps?

Andrew White, MD: It's crazy how many options have emerged in the last couple of years. I mean, it's hard for us to even keep track of the new therapies that are getting approved. And then, you know, thinking about if this is therapies approved for asthma, would we think it would work for polyps. That's been exciting. And probably over the next few years, we will just sort of stumble upon some other treatments that are going to work amazing, and at the same time probably teach us a lot about polyp disease in general. Because we will probably learn that something works well that we didn't anticipate. One of the things I'm excited about is tezepelumab. Tezepelumab is a monoclonal that's currently approved for asthma. It works at a very high level, sort of at the beginning of where a lot of this inflammation may happen in the mucosa. The target is something that's important, we know in AERD, which is a severe form of polyps that I've been very interested in. It has a lot of promise. I'm particularly excited about that. You know, I think there's a lot of other targets that are interesting. There's anti-siglec-8, which is on mast cells and eosinophils. And there's potential, you know, therapies in development that may target both of those cells. And I'm pretty interested in things that can do both, do double duty on eosinophils and mast cells.

Anju Peters, MD: Naveen, would you like to add anything else?

Naveen Bhandarkar, MD: Yes. The EDS-fluticasone that we have been talking about, which has a current FDA approved indication for polyps. As I think we mentioned earlier has gone through a trial, which met primary endpoints for treatment of chronic sinusitis, which in the FDA view is a separate disease state for whatever it's worth. And I'm excited to see what comes out of that. If approved, it would be the first FDA approved therapy we have for chronic sinusitis. That's very exciting. The second that is ongoing right now is use of a mometasone-eluting implant that can be used prior to surgery and is placed in a specific location in the middle meatus. That's going through trials right now, which may not be available for several months, but is another very exciting thing on the horizon.

Anju Peters, MD: How about you, Dareen? Anything you are excited about in terms of new treatment?

Dareen Siri, MD, FAAAAI, FACAAI: As you discussed at the very beginning, there's this, you know, huge section of patients. The majority who do not have nasal polyps, or perhaps they have nasal polyps and evolution. We just haven't quite recognized them, because they don't have free nasal polyps hanging in their nose. That, to me is the most exciting. Because right now, you know, I'm trying to have to, again, negotiate different medications that will help these patients without an FDA approval. And that that is the number one most exciting part is that now I'll have something that I can treat in the majority of my patients with, and something that is easily accessible, easy to prescribe, those kinds of things. And certainly, there are a lot of other cool medications coming down the pipeline. And in fact, some of the other research, not necessarily about therapies, but just, you know, phenotyping, and endotyping the patients. Kind of like, when you have with asthma and other diseases to see which drugs might work the best for them? Which therapies? Which interventions? And as we understand a bit more about, you know, this age of the sinuses, I think that that's the best part.

Transcript edited for clarity