Thousands of Britons suffering from a severe and debilitating sinus condition could soon see their lives transformed by a new generation of long-lasting drug treatments.
Regulatory green light for innovative therapies
This month, the Medicines and Healthcare products Regulatory Authority (MHRA) has approved two new drugs for private use: depemokimab and tezepelumab. These are biologic treatments designed to switch off the specific immune system reactions that drive severe inflammation.
In a further significant development, another drug called dupilumab is currently being appraised by the National Institute for Health and Care Excellence (NICE) for potential use on the NHS. An assessment for tezepelumab's NHS use is scheduled for January.
A condition far beyond the common cold
While winter sniffles are commonplace, for an estimated 11 per cent of UK adults with chronic rhinosinusitis, the problem is persistent and serious. The most severe form, known as chronic rhinosinusitis with nasal polyps (CRSwNP), causes a permanently streaming nose and often a devastating loss of smell and taste.
"The condition has long been overlooked, with few effective treatments available," say experts and charities. For tens of thousands with the severe form, the cause is largely unknown, leading to an overactive immune response that causes extreme inflammation and soft tissue growths called nasal polyps.
These polyps can block the olfactory nerves, severing the connection between the nose and the brain. Symptoms extend beyond a runny nose to include facial pressure, sleep disruption, and post-nasal drip.
Moving beyond steroids and repeated surgery
Traditional treatment has relied on steroid nasal sprays, antihistamines, and steroid tablets. When these fail, patients often face repeated surgeries to remove polyps, which frequently grow back. Long-term steroid use carries risks like weakened bones and cardiovascular issues.
Around 50 per cent of patients do not respond adequately to steroids and require an operation called functional endoscopic sinus surgery.
The new biologic drugs represent a paradigm shift. They target precise pathways in the immune system to calm the inflammatory response. Administered by injection—once every six months for depemokimab and monthly for the others—they have been shown to reduce polyps, relieve symptoms, and decrease reliance on steroids and surgery.
Professor Rami Salib, a rhinologist at University Hospital Southampton, notes growing evidence that these drugs "can improve symptoms, restore smell and reduce the need for repeated surgery."
Duncan Boak of the charity SmellTaste highlights the urgent need, stating, "People have multiple operations over the years to no avail and it has a huge impact on their quality of life."
For patients like 42-year-old IT engineer Lee Dovey from Dudley, who has lived with CRSwNP for four years, the condition has been "horrendous." He, like many others, welcomes the prospect of new, effective treatments that could offer lasting relief.
