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Treatment for patients with chronic rhinosinusitis with nasal polyps (CRSwNP) consists of nasal steroids, saline lavage, and endoscopic sinus surgery; however, many patients do not achieve adequate symptom relief, and polyps often return after surgery. Omalizumab (Xolair) is a monoclonal antibody against IgE that is FDA approved for asthma and chronic urticaria and is being investigated for CRSwNP.
In two industry-funded trials, 265 patients with severe CRSwNP were randomized to omalizumab or placebo; both groups also used intranasal mometasone spray. At 24 weeks, endoscopic nasal polyp scores and nasal congestion scores were significantly lower in the omalizumab group than in the placebo group, with no excess adverse events.