A 45-year-old patient with refractory chronic rhinosinusitis with nasal polyps (CRSwNP) despite topical steroids and previous FESS is being considered for biologic therapy. Which biologic agent is approved for CRSwNP and primarily targets the IL-4 receptor alpha chain?
- A Mepolizumab (anti-IL-5)
- B Benralizumab (anti-IL-5Rα)
- C Dupilumab (anti-IL-4Rα) ✓
- D Omalizumab (anti-IgE)
Correct answer: C. Dupilumab (anti-IL-4Rα)
Explanation
Dupilumab is a monoclonal antibody targeting the IL-4 receptor alpha subunit, which is shared by both IL-4 and IL-13 signaling pathways. It blocks both Th2 cytokines that drive eosinophilic inflammation in CRSwNP. It is FDA and EMA approved for CRSwNP in adults as add-on maintenance therapy for those with inadequate response to intranasal corticosteroids. Mepolizumab and benralizumab target IL-5 pathway (eosinophils); omalizumab targets IgE and is approved for asthma and chronic urticaria.
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.