Chronic rhinosinusitis with nasal polyposis (CRSwNP) is classified as an endotype 2 disease. Which biological agent targeting the shared cytokine signaling pathway of IL-4 and IL-13 is now approved for severe CRSwNP?
- A Omalizumab (anti-IgE)
- B Mepolizumab (anti-IL-5)
- C Dupilumab (anti-IL-4Rα) ✓
- D Benralizumab (anti-IL-5Rα)
Correct answer: C. Dupilumab (anti-IL-4Rα)
Explanation
Dupilumab targets the IL-4 receptor alpha subunit (IL-4Rα), which is shared between IL-4 and IL-13 signaling pathways, making it effective against both type 2 cytokines that drive eosinophilic inflammation in CRSwNP. It is FDA-approved for severe CRSwNP and significantly reduces polyp size and symptom scores. Omalizumab targets IgE and is approved for CRSwNP as well but via a different pathway. Mepolizumab and benralizumab target IL-5 pathway (eosinophil survival) and are approved primarily for severe asthma, with some evidence in CRSwNP.
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.