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Nasal polyposis and Asthma
Professor Claus Bachert discusses diagnosis and treatment guidelines for different types of nasal polyps patients.
Nasal polyposis is linked to asthma comorbidity. In Europe, 85% of nasal polyphilic patients have eosinophilic asthma, whereas in China it is only about 15%. The more eosinophilic the polyps are, the more likely the patient will have asthma comorbidity and recurrent disease. Prof Bachert is looking at those patients that are unable to benefit from topical steroids, oral steroids or surgery.
Dupilumab, a human anti-IL-4 receptor alpha antibody that blocks the IL-4 and IL-13 pathways, is being used to reduce the burden of nasal polyp disease and to treat the comorbid asthma. Although nasal polyposis is infrequent, if you see a patient with late onset asthma, ask the patients if they have a nasal obstruction or loss of smell, and do a CT scan or a nasal endoscopy. Nasal polyposis is associated with uncontrolled asthma, and surgery is an option, but it doesn’t solve the problem in about 25% of patients. There are Phase III studies underway with monoclonal antibodies to treat nasal polyposis, so there is a lot of hope for this patient population.