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Published in: Drugs 11/2005

01-08-2005 | Review Article

Pharmacological Management of Nasal Polyposis

Authors: Prof. Dr Claus Bachert, Jean-Baptiste Watelet, Philippe Gevaert, Paul Van Cauwenberge

Published in: Drugs | Issue 11/2005

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Abstract

Nasal polyposis affects nearly 4% of the total population in Western countries, and presents a real challenge to the physician because of its severity, chronicity and recurrence rate. Characteristic histomorphological features of polyps are an eosinophilic inflammation and the destruction of connective tissue; recent research has focused on cytokines, chemokines, growth factors and metalloproteinases to explain these features, as the aetiology of nasal polyposis remains largely unclear. Currently, topical and systemic corticosteroids are first-choice drug therapy approaches, and good evidence from controlled trials is available for topical, but not for systemic, corticosteroid therapy. Surgery is indicated if adequate drug treatment fails, which often needs to be maintained after surgery. There is limited experience for other drugs, such as antihistamines, leukotriene antagonists and frusemide (furosemide), which may be added to corticosteroid therapy in selected patients. Aspirin (acetylsalicylic acid) desensitisation may be a therapeutic option for patients who do not respond to corticosteroids or surgery. Recently, antibiotics such as macrolides have been suggested to have therapeutic activity based on their anti-inflammatory properties but large-scale controlled trials are lacking. New approaches are currently evolving, specifically targeting eosinophilic recruitment (chemokine receptor 3, eotaxin) and inflammation (interleukin-4, -5, -13), immunoglobulin-E, or tissue remodeling by reducing the activity of metalloproteinases.
This review summarises current knowledge on pathogenesis as well as established and future approaches in the pharmacological management of bilateral eosinophilic nasal polyposis.
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Metadata
Title
Pharmacological Management of Nasal Polyposis
Authors
Prof. Dr Claus Bachert
Jean-Baptiste Watelet
Philippe Gevaert
Paul Van Cauwenberge
Publication date
01-08-2005
Publisher
Springer International Publishing
Published in
Drugs / Issue 11/2005
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200565110-00006

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