A 45-year-old patient with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) fails 3 months of maximal medical therapy (topical steroid, nasal irrigation, systemic steroid course). Which biological agent is FDA-approved (and available in India) as add-on therapy for CRSwNP?
- A Dupilumab (anti-IL-4Rα, targeting IL-4 and IL-13 signaling) ✓
- B Mepolizumab (anti-IL-5)
- C Omalizumab (anti-IgE)
- D Benralizumab (anti-IL-5Rα)
Correct answer: A. Dupilumab (anti-IL-4Rα, targeting IL-4 and IL-13 signaling)
Explanation
Dupilumab (anti-IL-4 receptor alpha monoclonal antibody) blocks signaling of both IL-4 and IL-13, the key Type 2 inflammatory cytokines driving eosinophilic CRSwNP. It is the first FDA-approved (2019) and EMA-approved biologic specifically indicated for CRSwNP in adults on maximal medical therapy. Mepolizumab is approved for severe asthma; omalizumab for allergic asthma/CRSwNP (approved 2020 for CRSwNP in the EU); benralizumab is under investigation for CRSwNP but not yet approved for this indication as a primary indication.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.