Look beyond the symptoms to identify and manage Patients with Type 2 Inflammation

Identify > Target > Treat

Identify

80% of Patients with CRSwNP Have Type 2 Inflammation^1,a

Look for other signs of type 2 inflammation in patients with CRSwNP^2,3

History of asthma and/or other Type 2 comorbidities (allergic rhinitis, NSAID-ERD, etc.)

and/or

Elevated EOS and/or elevated total IgE levels

and/or

Need for systemic corticosteroids

Consider type 2 inflammation as the key underlying cause of CRSwNP^4,5

~3x more revision surgeries in CRSwNP patients with coexisting asthma⁶

50% of CRSwNP patients have coexisting asthma⁷

Abbreviations

EOS, eosinophils; NSAID-ERD, nonsteroidal anti-inflammatory drug-exacerbated–respiratory disease.

Target

Target key and central drivers of Type 2 Inflammation

IL-4 and IL-13 are key and central drivers of Type 2 inflammation in CRSwNP^4,5

Tissue remodeling, polyp formation, and symptoms, including nasal obstruction, nasal discharge, and loss of smell

Abbreviation

ILC2, type 2 innate lymphoid cells.

Target Key and Central Drivers of Type 2 Inflammation

IL-4, IL-13, and IL-5 have distinct and overlapping roles with a broad impact on CRSwNP symptoms^4,5

	IL-14	IL-3	IL-5
Th2 cell differentiation	✓
B-cell class switching and IgE production	✓	✓
Epithelial barrier dysfunction, goblet cell hyperplasia, and mucus hypersecretion	✓	✓
Tissue remodeling and polyp formation	✓	✓
Eosinophilic recruitment and trafficking to nasal mucosa and polyp tissue	✓	✓	✓
Eosinophil differentiation in bone marrow			✓

Current Standard-of-Care does not specifically target chronic underlying Type 2 Inflammation

Systemic corticosteroids

Treat inflammation broadly³
Frequent use leads to risk of short-term and long-term adverse effects⁸

Targeting Type 2 inflammation can help you achieve treatment goals.

Sino-nasal surgery

Removes nasal obtrsuction, but does not aedssd r underlying chronic type 2 inflammation, which may lead to polyp recurrence and refractory symptoms^2,3
Many patients don't ecrover their sense of s m ell after surgery⁹
Revision sugrery is saosciated with an ienacsred risk of surgical complications^10,11

Many patients with Type 2 inflammation experienced Polyp recurrence within 5 years of Sino-nasal surgery¹²

Type 2 inflammation is the underlying cause of CRSwNP in 80% of patients1

Treat

Consider a Biologic that targets Type 2 Inflammation in patients with uncontrolled CRSwNP

Type 2 inflammation is the underlying cause of CRSwNP in 80% of patients¹
IL-4 and IL-13 are key and central type 2 cytokines in the pathophysiology of CRSwNP
- IL-4, IL-13, and IL-5 are key type 2 cytokines^4,5
CRSwNP and asthma frequently coexist, adding substantially to the overall disease burden and limiting the effectiveness of surgery and systemic steroids^1-3,13-16
Guidelines recommend use of biologics in CRSwNP patients to address type 2 inflammation^2,3

Guidelines

Guidelines Recommend Use of Biologics in CRSwNP Patients to Address Type 2 Inflammation

EPOS and EUFOREA recommend biological treatments for patients with bilateral polyps who have had prior ESS if they meet at least 3 of the 5 following criteria^2,3:

Evidence of Type 2 Inflammation^a
Need for systemic corticosteroids or contraindication to systemic steroids
Significantly impaired quality of life
Significant loss of smell
Diagnosis of comorbid asthma

In patients who have had no prior sinus surgery, 4 out of 5 criteria should be fulfilled²

^a Tissue EOS ≥10/hpf, OR blood EOS ≥250, OR total IgE ≥100.