Biologics for the Treatment of Allergic Rhinitis, Chronic Rhinosinusitis, and Nasal Polyposis

William Eschenbacher; Matthew Straesser; Alice Knoeddler; Rung-Chi Li; Larry Borish

doi:10.1016/j.iac.2020.06.001

Biologics for the Treatment of Allergic Rhinitis, Chronic Rhinosinusitis, and Nasal Polyposis

Immunol Allergy Clin North Am. 2020 Nov;40(4):539-547. doi: 10.1016/j.iac.2020.06.001. Epub 2020 Sep 9.

Authors

William Eschenbacher¹, Matthew Straesser¹, Alice Knoeddler¹, Rung-Chi Li¹, Larry Borish²

Affiliations

¹ Department of Medicine, Asthma and Allergic Disease Center, University of Virginia Health Systems, Charlottesville, VA 22908-1355, USA.
² Department of Medicine, Asthma and Allergic Disease Center, University of Virginia Health Systems, Charlottesville, VA 22908-1355, USA; Department of Microbiology, Asthma and Allergic Disease Center, University of Virginia Health Systems, Charlottesville, VA 22908-1355, USA. Electronic address: lb4m@virginia.edu.

Abstract

Allergic rhinitis (AR), most presentations of nasal polyposis (NP), and many presentations of chronic rhinosinusitis are type 2^high disorders characterized by expression of interleukin (IL)-4, IL-5, and IL-13. Neutralization of IgE with anti-IgE (omalizumab) has proven efficacy in AR. Similarly, in addition to anti-IgE, blockade of IL-5/IL-5 (mepolizumab, reslizumab, benralizumab) and dual blockade of IL-4 and IL-13 with anti-IL-4R (dupilumab) have demonstrated efficacy in NP. However, these agents are expensive and future studies are essential to evaluate cost effectiveness in comparison with current medical and surgical therapies. This article reviews biologics as potential interventions in AR, chronic rhinosinusitis, and NP.

Keywords: Allergic rhinitis; Chronic rhinosinusitis; Eosinophils; IgE; Interleukins; Nasal polyposis; Type 2 inflammation.

Publication types

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

MeSH terms

Biological Products / economics
Biological Products / pharmacology
Biological Products / therapeutic use*
Chronic Disease / drug therapy
Chronic Disease / economics
Cost-Benefit Analysis
Drug Costs
Humans
Immunoglobulin E / metabolism
Interleukin-13 / metabolism
Interleukin-4 / metabolism
Interleukin-4 Receptor alpha Subunit / antagonists & inhibitors
Interleukin-4 Receptor alpha Subunit / metabolism
Interleukin-5 / antagonists & inhibitors
Interleukin-5 / metabolism
Nasal Polyps / diagnosis
Nasal Polyps / drug therapy*
Nasal Polyps / economics
Nasal Polyps / immunology
Rhinitis, Allergic / diagnosis
Rhinitis, Allergic / drug therapy*
Rhinitis, Allergic / economics
Rhinitis, Allergic / immunology
Severity of Illness Index
Signal Transduction / drug effects*
Signal Transduction / immunology
Sinusitis / diagnosis
Sinusitis / drug therapy*
Sinusitis / economics
Sinusitis / immunology
Treatment Outcome

Substances

Biological Products
IL4 protein, human
IL4R protein, human
IL5 protein, human
Interleukin-13
Interleukin-4 Receptor alpha Subunit
Interleukin-5
Interleukin-4
Immunoglobulin E

Abstract

Publication types

MeSH terms

Substances

Grants and funding