Multitarget Antibodies Explored for Severe Nasal Polyps

ANTIBODIES DESIGNED to recognise more than one target are being explored as potential treatments for chronic rhinosinusitis with nasal polyps, according to a review examining the rationale for broader inflammatory pathway inhibition.

The authors consider whether dual- and multispecific antibodies could improve control in selected patients. Their central question is whether additional targets would deliver meaningful clinical benefit beyond well-chosen existing therapy.

A Condition with Persistent Symptoms

Nasal polyps are soft growths inside the nose that can cause obstruction, a runny nose and a reduced sense of smell. When they block the sinuses, they may also contribute to sinusitis symptoms.

Treatment commonly includes steroid nasal sprays or drops, with short courses of steroid tablets or surgery considered in some cases. Surgery can improve symptoms, but polyps may return, and ongoing nasal treatment may still be needed. NHS

This recurring pattern helps explain the interest in treatments directed at the inflammatory processes involved in severe disease.

Why Responses Differ

Existing biologics have expanded treatment options, yet their effects vary between patients and across outcomes.

An incomplete response may reflect a mismatch between the chosen target and the patient’s disease, associated asthma, persistent tissue changes or inflammatory pathways that remain active.

The review cautions that limited improvement with one biologic does not automatically mean that several pathways need to be blocked simultaneously.

Considering Multispecific Antibodies

Dual- and multispecific antibodies incorporate the ability to bind more than one target within a single molecule. The proposed advantage is coordinated treatment of complementary disease mechanisms.

However, broader targeting is a biological strategy, not proof of better care. The review identifies a need for comparative evidence, appropriate patient selection and acceptable long-term safety.

No validated biomarker currently establishes which patients specifically require this approach. Springer Nature Link

What Better Control Would Mean

For patients, treatment success can involve several priorities: easier nasal breathing, improved smell, better quality of life or fewer courses of systemic steroids and repeat operations.

These goals are related but not interchangeable. A reduction in polyp size alone would not necessarily answer every question about the value of a new treatment.

An informative clinical comparison would therefore need to assess the outcomes that remain troublesome despite existing care, alongside treatment burden and adverse effects.

The review provides a framework for evaluating an emerging treatment approach rather than a recommendation to replace established biologics. Future studies will need to show where multitarget antibodies offer additional benefit and whether that benefit is sufficient to justify their use over optimised current treatment.

Reference

Dai Y et al. Rethinking Monospecific Antibody Therapy in Chronic Rhinosinusitis with Nasal Polyps: Dual- and Multispecific Antibodies. Clin Rev Allergy Immunol. 2026;69:81.