Tezepelumab Eases Chronic Rhinosinusitis With Nasal Polyps

TOPLINE:

Tezepelumab reduced the size of nasal polyps and the severity of nasal congestion in patients with severe, uncontrolled chronic rhinosinusitis with nasal polyps, in a placebo-controlled study.

METHODOLOGY:

• Tezepelumab, a monoclonal antibody that blocks thymic stromal lymphopoietin, is approved as an add-on maintenance treatment for severe asthma.
• To examine the efficacy and safety of the medication in severe, uncontrolled chronic rhinosinusitis with nasal polyps, researchers conducted a phase 3 trial in 10 countries from April 2021 to August 2023.
• The 52-week study included 408 patients (mean age, 49.7 years; 65.2% men) who received standard care treatment with intranasal glucocorticoids and were randomly assigned to receive either a 210-mg dose of tezepelumab or placebo subcutaneously every 4 weeks.

TAKEAWAY:

• At week 52, patients who received tezepelumab showed greater improvements in total nasal polyp score and nasal congestion score, the coprimary endpoints, than those who received placebo (least-squares mean difference, −2.07 and −1.03 respectively; both P < .001).
• Improvement started as early as week 4 and week 2, respectively, the researchers reported.
• Sense of smell also improved more in patients who received tezepelumab.
• Decisions to treat with nasal polyp surgery or systemic glucocorticoids were significantly less common in patients who received tezepelumab than in those who received placebo (5.7% vs 30.6%).

IN PRACTICE:

“These findings build on the reported efficacy of tezepelumab in patients with severe, uncontrolled asthma and coexisting chronic rhinosinusitis with nasal polyps and suggest that the reduction in multiple downstream inflammatory signaling may modify disease severity in the patients who participated in the present trial,” the authors of this study wrote. 

SOURCE:

Joseph K. Han, MD, with Eastern Virginia Medical School in Norfolk, Virginia, was the corresponding author for the study, which was published online on March 1 in The New England Journal of Medicine. The results were also presented at the American Academy of Allergy, Asthma, & Immunology/World Allergy Organization 2025 Annual Meeting.

LIMITATIONS:

The trial included patients with coexisting asthma, but the study was not designed to characterize asthma severity.

DISCLOSURES:

This study was supported by AstraZeneca and Amgen, the companies that are developing and manufacturing tezepelumab. Several study authors declared being employees of or consultants for those companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.