Efficacy of omalizumab in the treatment of severe chronic rhinosinusitis with polyposis (CRSwNP)

Introduction CRSwNP is a widespread, heterogeneous disease. For therapy, in addition to intranasal corticosteroids (INCS) and surgical remediation, the use of biologics has recently become available. The present study investigated the efficacy of omalizumab in patients with severe CRSwNP.

Methods Adults with severe CRSwNP (n=11) and inadequate response to INCS were treated with 150 to 450 mg omalizumab every four weeks depending on total IgE and body weight. The observation period was 16 weeks so far. Changes in nasal polyp score (NPS) from baseline to week 16 were examined, as well as impact on quality of life using the SNOT-20 score and olfaction using the Sniffin' Sticks. Data collection will be completed in April 2022.

Results During the observation period (Oct 2020 – Nov 2021), 10 of 11 participants completed visit 4 (V4, 5th omalizumab injection). There was a significant reduction in NPS (V1=4.9±0.94, V4=3.2±1.32, p<0.01). Furthermore, both an improvement in quality of life (V1=40.6±15.8, V4=27±18.1, p<0.01) and olfaction (threshold: V1=1.2±0.3, V4=3.4±2.8, p<0.01, identification test: V1=4.9±4.4, V4=6.0±4.0, p=0.03) could be demonstrated. Only one patient showed no response to omalizumab during 16 weeks of use.

Conclusion On the basis of the studies, a positive influence of omalizumab in add-on therapy in patients with severe CRSwNP could be demonstrated. Besides a reduction of the polyp size and the improvement of the smelling ability, an increase of the quality of life could be shown.

M. Cuevas, T. Hummel, T. Zahnert

Conflict of Interest

The author declares that there is no conflict of interest.

Publication History

Article published online:
24 May 2022