Chronic Sinusitis Treatment Evolves with New Biologics
The treatment landscape for chronic rhinosinusitis with nasal polyps (CRSwNP) is expanding with new biologic therapies targeting diverse inflammatory pathways, significantly altering the care paradigm.
The management of chronic rhinosinusitis with nasal polyps (CRSwNP) is entering a more diverse treatment era, moving beyond traditional intranasal corticosteroids, intermittent systemic steroids, and endoscopic sinus surgery. New biologic therapies are increasingly targeting specific inflammatory pathways implicated in the condition.
Key developments include Dupixent's inhibition of the IL-4/IL-13 pathway and Xolair's IgE-targeted treatment. Nucala has also entered the market by inhibiting IL-5. More recently, Tezspire received U.S. approval in October 2025 as the first biologic targeting TSLP for CRSwNP patients.
International competition is also growing. Kangyueda (stapokibart; CM310), an anti-IL-4Rα monoclonal antibody from Keymed Biosciences, was approved in China in December 2024. Additionally, Exdensur (depemokimab) has gained approvals in the UK, EU, Japan, and Canada. Its extended-half-life anti-IL-5 mechanism and twice-yearly dosing offer significant convenience and adherence advantages.
Future success in CRSwNP treatment will depend on durable reductions in nasal polyp burden and congestion, rapid restoration of smell, and minimizing the need for systemic corticosteroids and surgery. Broad efficacy across different inflammatory profiles, convenient dosing, and reliable long-term safety will be crucial differentiators.