One of the recent focuses of medicine has been to offer personalized treatment specific to the exact cause of an individual’s disease. A recently developed class of medications, “biologics”, looks to address this need for personalization in healthcare.
Biologics first became approved for the treatment of sinusitis in July of 2019. We now have two different biologics approved (dupilumab and omalizumab) and several more on the horizon. Of note, this class of medication is currently available only for patients with chronic sinusitis who have nasal polyps. Nasal polyps are typically identified by your ENT when you undergo a nasal endoscopy (when a small camera is used to look in your nose; performed easily, quickly and comfortably in the office). Clinical trials involving each of these medications has shown improvement in patient’s daily nasal symptoms and decrease in the size of nasal polyps when compared to patients who use just nasal steroid sprays.
When is the best time and for how long to use biologics in chronic sinus disease is still undetermined. Most doctors are treating their sinus patients with topic steroids and salt water (saline) nasal rinses and then offering surgery if patients do not improve on this regimen. If patients continue to have severe symptoms after sinus surgery and have re-growth of nasal polyps, doctors are now offering biologics. Other doctors are offering biologics to sinus patients who want an alternative to surgery or in patients who are unable to have sinus surgery. As more research comes out, this will continue to be an evolving and exciting topic for patients with chronic sinus disease.
Other things to consider with biologics is that these medications are not something you take by mouth. Instead these are medications which are injected under your skin usually once or twice per month depending on certain factors your doctor will help determine. Side effects depend on which medication who receive but are generally well tolerated. These medications are new to sinus disease but have been around since 2003 for omalizumab and 2017 for dupilumab and therefore we know a lot about their safety profile and can talk in detail with you when deciding if this medication is right for you.
If you are interested, please reach out to your doctor to see if these medications are right for you.
As always, the content in this blog is meant to be informational and not serve as a substitute for a medical evaluation with a physician.