July 18, 2019

New Drug to Treat Nasal Polyps - Dupilumab (Dupixent)

Patients who suffer from nasal polyps suffer from significant nasal obstruction, smell loss, and congestion. This condition is not normally "curable" and requires medical management for long-term symptom control. Traditional treatment includes surgical removal, leukotriene inhibitor (ie, singulair), intranasal steroids, allergy shots (if applicable), and oral steroids.

In the majority of patients, this treatment management usually controls nasal polyp recurrence/growth such that surgical removal may be spaced many years apart.

However, in a minority of patients, in spite of surgery and medications, the nasal polyps quickly come back causing symptoms to recur in less than 1 year.

For such nasal polyp treatment-resistant patients, a new FDA-approved drug called dupilumab (or Dupixent) is now available that works astoundingly well for adult patients. Approved June 26, 2019, the drug is administered 300mg subcutaneously every other week either to the thigh or abdominal regions in a rotating schedule (behind the arm also OK if administered by a healthcare professional). The drug can be administered either in the office or at home depending on patient comfort levels. (Administration is analogous to insulin shots.)

This medication can also be considered in nasal polyp patients who have never undergone surgery if there is some type of contraindication for surgical intervention (such as being on a required blood thinner or medical problems that make anesthesia too high a risk such as a recent heart attack or stroke).

This drug also directly helps patients who also suffer from Sampter's triad and significant asthma.

Personally, I feel this medication to be a game-changer in the medical management of nasal polyps.

Our office now provides prescriptions for this medication which can only be filled at specialty pharmacies. Once filled, the drug gets shipped directly to the patient's home.

Full prescribing information can be found here.

Side effects from dupilumab is shown below:

The injection site adverse reaction can be minimized by ensuring the drug is at room temperature prior to injection (given the drug is kept refrigerated when stored).

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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