Do anti-IL-5 drugs work for chronic rhinosinusitis with nasal polyps?

Anti-IL-5 drugs are effective treatments for chronic rhinosinusitis with nasal polyps (CRSwNP). These medicines target a specific part of the immune system to reduce inflammation. Research shows they help patients breathe better, smell again, and feel less congestion. Some patients also need surgery to remove polyps, and combining drugs with surgery can provide the best results.

What the research says

A 2024 trial found that tezepelumab significantly improved smell and taste scores over fifty-two weeks. Patients taking the drug showed better results on standard tests for smell loss compared to those taking a placebo. Improvements were seen as early as four weeks and continued through the end of the study ¹.

Mepolizumab is another anti-IL-5 drug approved for this condition. Studies show it helps reduce nasal polyp size and improves lung function in patients who also have asthma. When mepolizumab was used alone, patients still saw improvements in inflammation and symptoms. However, adding functional endoscopic sinus surgery to mepolizumab produced greater gains in polyp scores and overall symptom burden ³.

A systematic review confirms that IL-5 is central to the disease process because it drives eosinophil survival and activation. Blocking this pathway with biologics like mepolizumab or tezepelumab can restrain these inflammatory changes. This approach is part of a broader strategy that includes other approved biologics like dupilumab and omalizumab to manage severe cases ²⁴.

What to ask your doctor

• Do I have the specific type of inflammation that responds to anti-IL-5 drugs?
• Will combining an anti-IL-5 drug with surgery give me better long-term results than the drug alone?
• How quickly should I expect to see improvements in my sense of smell or breathing?
• Are there other biologics like dupilumab or omalizumab that might work better for my specific case?
• What are the risks of stopping the medication if my symptoms return?