N Engl J Med

AAAAI 2025: Tezepelumab shows promise in reducing nasal polyps, need for surgery

March 4, 2025

Tezepelumab could significantly reduce the burden of nasal polyps, minimizing the need for surgery and long-term corticosteroid use, thus improving patient outcomes and quality of life. These findings were shared at the American Academy of Allergy Asthma & Immunology (AAAAI)/World Allergy Organization (WAO) Joint Congress in San Diego, CA.

Study details: In the phase 3 WAYPOINT trial, adults with physician-diagnosed, symptomatic, severe chronic rhinosinusitis with nasal polyps were randomly assigned to receive standard care plus either tezepelumab 210 mg (n = 203) or placebo SC (n = 205) every 4 weeks for 52 weeks. The coprimary endpoints were changes from baseline in the total Nasal Polyp Score (NPS) (range, 0 to 4 per nostril) and the mean nasal-congestion score (NCS) (range, 0 to 3) at week 52. Key secondary endpoints included the loss-of-smell score, total score on the Sinonasal Outcome Test, Lund–Mackay score, total symptom score, and time-to-event analyses for the first decision to treat with nasal-polyp surgery or systemic glucocorticoid therapy.

Results: Tezepelumab significantly reduced nasal polyp severity, with an NPS change of -2.07 (95% confidence interval [CI], -2.39 to -1.74) and NCS change of -1.03 (95% CI, -1.20 to -0.86) compared with placebo. Improvements were observed as early as week four for NPS and week two for NCS, sustained through week 52. The need for nasal polyp surgery was drastically lower in the tezepelumab group (0.5% vs. 22.1%), and there was a significant reduction in systemic glucocorticoid use (5.2% vs. 18.3%).

Source:

Lipworth, B., et al. (2025, March 1). N Engl J Med. Tezepelumab in Adults with Severe Chronic Rhinosinusitis with Nasal Polyps. https://www.nejm.org/doi/full/10.1056/NEJMoa2414482