If you have lived with chronic sinusitis for years, you know the routine. Rinses, sprays, another course of something, maybe a surgery, and the symptoms creep back. For a long time medicine had little to offer beyond that routine. Until 2019 there was not one biologic medicine approved for this disease, and if you had the form without nasal polyps, you had no approved drug of your own at all until 2024.
That has changed fast, and more is coming. Here is the full picture: what is approved today, what doctors actually reach for, what researchers are testing right now, and why the answers took so long to arrive.
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What's approved right now
Five drugs are approved in the US specifically for chronic sinusitis, and four of them showed up in just the last few years.
Dupilumab (Dupixent), approved 2019. The first-ever biologic approved for chronic sinusitis with nasal polyps. It's an injectable antibody that calms a specific type of inflammation (called type 2) that causes polyps to grow.
Omalizumab (Xolair), approved 2020. Another injectable antibody for the nasal polyps form, this one targeting the allergic side of that same inflammation.
Mepolizumab (Nucala), approved 2021. Targets eosinophils, the inflammatory cells that build up in polyp tissue.
Fluticasone exhalation delivery system (Xhance), approved for polyps in 2017 and for chronic sinusitis without polyps in March 2024. This one matters more than it might seem. It's a steroid delivered through a device you actually breathe out into, which pushes the medicine deeper toward the sinuses. The 2024 approval made it the first and only drug ever approved for chronic sinusitis without nasal polyps, before that, people with this form of the disease had nothing approved for them at all.
Tezepelumab (Tezspire), approved 2025. The newest biologic for the nasal polyps form, approved after the WAYPOINT trial (more on that below).
So here's the scoreboard: zero biologics before 2019, four by 2025. Very few diseases have seen progress move that fast.
What about the medicines you've probably already tried?
Most people reading this have never used a biologic. The everyday tools are saline rinses and steroid nasal sprays, and for most people, that's where treatment starts, and often stays. Rinses clear out mucus and irritants from the nasal passages. Steroid sprays target the inflammation itself, which is the real underlying problem.
Antibiotics are what patients ask about most, and the honest answer is: they treat a different problem entirely. Chronic sinusitis is defined by inflammation that lasts 12 weeks or longer, not by a bacterial infection that a round of antibiotics can clear up. Antibiotics come into play only when an acute bacterial infection flares up on top of the chronic condition. This is exactly why "just one more round of antibiotics" so often doesn't break the cycle: the actual inflammation was never the target. What to take, and when, is something to talk through with your doctor, our post on chronic sinusitis medication covers the standard options in more detail.
What researchers are studying now
Tezepelumab and the WAYPOINT trial. In March 2025, Amgen and AstraZeneca announced positive results from a large study, published in the New England Journal of Medicine. People with nasal-polyp chronic sinusitis who took tezepelumab had noticeably smaller polyps and less nasal congestion than people taking a placebo. The result that really got doctors' attention: the drug significantly reduced how often people needed sinus surgery. That's a big deal, since repeat surgery has long been the fallback option when medications stop working. These results led to the drug's US approval later that year.
Depemokimab and the ANCHOR trials. GSK's depemokimab is an antibody that's only given once every 6 months, and it's already approved in the US for severe asthma. In two large trials (called ANCHOR-1 and ANCHOR-2) presented in 2025, it produced real, measurable improvements in polyp size and nasal blockage. Getting just two injections a year instead of a shot every few weeks could genuinely change what living with a biologic feels like day to day. The FDA has accepted the application for the nasal-polyp form, and a decision is expected soon.
Lebrikizumab, the next drug in line for the polyps form. Eli Lilly is running a large study of lebrikizumab in people with nasal-polyp chronic sinusitis, currently recruiting 510 participants. A trial of that size is exactly how a drug moves from "promising" to "approvable," and it's one of the bigger industry-run studies happening in this condition right now.
And the bigger picture. As of August 2026, about 61 studies for chronic sinusitis are recruiting in the US, and that number changes often. AstraZeneca runs the largest industry-backed program, while academic centers like the Medical University of South Carolina, the University of Alabama at Birmingham, UCLA, Cedars-Sinai, and Northwestern are running their own research. Roughly half of these studies aren't testing drugs at all; they're looking at devices, surgical techniques, sinus rinse methods, or simply observing how the disease behaves over time. If you're not interested in trying a new medication, these kinds of studies are a way to still take part in research. One example: the University of Illinois at Chicago is testing whether probiotic sinus rinses can help, a small study focused on the bacteria that live in the sinuses rather than on the immune system.
Why research in this field takes time
The measurement problem. There's no single blood test for chronic sinusitis. Trials have to measure success in two different ways at once: a doctor checks the polyps through a small camera, and the patient rates how blocked their nose feels day to day. Larger trials also track quality of life using a standard questionnaire (called SNOT-22) and count how many people still end up needing surgery or steroids. All of this takes years to run per trial. It also means two different studies can both technically succeed while measuring slightly different things, which makes it harder to directly compare drugs against each other.
The two-disease problem. Chronic sinusitis is really two separate conditions: with nasal polyps, and without. Almost all the recent progress has happened on the polyps side, because that form has a clearer inflammation pattern that researchers can target. The non-polyps form didn't get its first approved drug until 2024. That side of the disease is now the real frontier, and it's where researchers most need volunteers.
The surgery question. For decades, surgery was the best option available, but polyps often grew back afterward. Newer trials are asking a tougher question: can a medication actually reduce the need for surgery altogether? Answering that means following patients for a long time to see whether surgery gets avoided completely, not just delayed, which is another reason results take a while to come in.
Does chronic sinusitis affect more than your sinuses?
Often, yes. Asthma frequently shows up alongside the nasal-polyp form. Allergic rhinitis, acid reflux, and aspirin sensitivity are common companions too. That specific combination: asthma, plus nasal polyps, plus a reaction to aspirin, even has its own name: aspirin-exacerbated respiratory disease (AERD), sometimes called Samter's triad. This matters practically, because it affects both how you're treated and which studies you might qualify for.
And the impact goes beyond just your nose. Studies using quality-of-life scores have found that chronic sinusitis affects people at a level comparable to other major chronic diseases, with real effects on sleep, mood, and productivity.
If you have chronic sinusitis along with asthma or aspirin reactions, mention it to your doctor, that combination shapes both your treatment and which trials you might be a good fit for. Some studies are built specifically around these overlaps: Indiana University is running a study of sinus treatments in people who have chronic sinusitis together with cystic fibrosis.
Rhinitis vs. sinusitis: what's the difference?
People often use these two words as if they mean the same thing, and honestly, doctors kind of agree. Rhinitis is inflammation of the lining of the nose. Sinusitis is inflammation of the sinuses (the air spaces in the bones around your nose). In real life, the two almost always happen together, which is exactly why the medical name for this condition is "chronic rhinosinusitis" rather than just "chronic sinusitis". Tthe nasal passages are inflamed right along with the sinuses in nearly every case.
The distinction that actually matters for patients isn't rhinitis vs. sinusitis, it's allergic vs. chronic. Allergic rhinitis is a reaction to something you breathed in, comes with sneezing and itching, and goes away once the trigger is gone. Chronic rhinosinusitis is inflammation that sticks around for 12 weeks or more, with nasal blockage, drainage, facial pressure, and a reduced sense of smell, and it doesn't resolve on its own. Allergic rhinitis is also one of the conditions that commonly shows up alongside chronic sinusitis, so plenty of people end up with both at the same time.
What is fungal sinusitis?
Sometimes fungi are the cause instead of the usual viruses or bacteria, and that changes things. Fungal sinusitis comes in two types: noninvasive and invasive. The noninvasive kind stays on the surface and mostly affects people with normal, healthy immune systems. This includes a fungal ball, saprophytic fungal sinusitis, and allergic fungal rhinosinusitis (AFRS). The invasive kind goes deeper into the tissue and shows up far more often in people with weakened immune systems: diabetes, chemotherapy, long-term steroid use, and immunosuppression in general all raise the risk.
AFRS is the type that overlaps most with the rest of the chronic sinusitis story. It's an allergic reaction to fungi, mostly in people who are already prone to allergies, and heavy nasal polyp buildup is one of the main signs doctors look for when diagnosing it. It shows up more often in hot, humid climates. In one study from Louisiana, AFRS made up roughly 5 to 10 percent of chronic sinusitis cases there.
Common myths
"It's contagious."
No. Chronic sinusitis is long-lasting inflammation, not an infection you can pass to someone else. You can't catch it from a partner or coworker. The nuance worth knowing: the germs behind short-term sinus infections do spread. Most acute sinus infections start with a virus, usually the same kind that causes a common cold, and those viruses and bacteria do travel between people. So someone can give you a cold that triggers a flare-up, without ever giving you the actual chronic disease.
"It's just a sinus infection that won't quit."
A regular sinus infection usually clears up within about 4 weeks. Chronic sinusitis means the inflammation sticks around for 12 weeks or longer, even with treatment. It's a genuinely different problem, and gets studied differently too.
"A constant headache means chronic sinusitis."
Usually, no. Doctors only connect headaches to this disease when they show up together with nasal blockage, drainage, and reduced smell lasting 12 weeks or more. A headache on its own deserves its own separate checkup.
"Antibiotics will fix it eventually."
They won't fix the chronic part, because the chronic part isn't a bacterial infection. Antibiotics can help during acute flare-ups, but they don't do anything to reverse the underlying inflammation. This is one of the costlier myths out there, in wasted prescriptions and wasted time.
"Surgery is the end of the road."
Surgery opens up blocked passages and removes polyps, and it genuinely helps a lot of people. But polyps often grow back, which is exactly why so much current research is focused on what happens after surgery, or on avoiding it in the first place.
The two forms, and what care usually looks like
Chronic sinusitis doesn't have a staging system. Instead, it splits into two forms, and knowing which one you have tells you which studies might be a fit for you.
With nasal polyps (CRSwNP). Soft growths form inside the nose and sinuses, caused by a specific type of inflammation (called type 2, or eosinophilic). Care usually starts with saline rinses and steroid sprays. When polyps keep blocking breathing or your sense of smell, doctors often discuss surgery, and if inflammation keeps coming back after that, one of the four approved biologics. This form tends to be diagnosed in adults in their 40s to 60s and is more common in men. Most drug trials focus on this group, including head-to-head drug comparisons and studies testing different dosing schedules, because the inflammation here is easier to measure and target.
Without nasal polyps (CRSsNP). The same kind of persistent inflammation, just without the growths. Care relies on rinses and steroid sprays, and since March 2024, there's one approved drug (Xhance). Treatment options are limited here mainly because this form's inflammation doesn't have one clear, targetable signature. That makes this the real frontier for new research, and eligibility for trials can actually be broader than people expect, since researchers aren't screening based on polyp size.
How to find a chronic sinusitis study
AllClinicalTrials.com lists recruiting chronic sinusitis studies in one place, from biologic trials to irrigation and observational studies. One example: Indiana University is running a study on sinus treatments in people who have chronic sinusitis together with cystic fibrosis. You can browse by location, check eligibility basics in plain language, and apply in about 5 minutes. The study team then contacts you and talks through every detail before anything is decided.
Common questions
What is chronic sinusitis, in simple terms? Chronic sinusitis is swelling and irritation inside your nose and sinuses that just won't settle down. It sticks around for at least 12 weeks, even with treatment. That's what separates it from a regular sinus infection, which usually clears up in about a month. Most people notice a nose that stays blocked, mucus that keeps draining, pressure across the face, and a fading sense of smell.
What causes chronic sinusitis? It's ongoing inflammation of the sinus lining, not a single infection you can point to. Asthma, allergic rhinitis, acid reflux, and aspirin sensitivity often show up alongside it and may play a role. For many people, the exact trigger is never fully clear.
What are the symptoms of chronic sinusitis? The four main symptoms are a blocked nose, mucus draining from the nose or down the throat, pressure or pain in the face, and a weaker sense of smell. Timing is the key part: these symptoms have to last 12 weeks or more, even with treatment, before doctors call it "chronic." A headache on its own isn't enough, doctors only connect headaches to this condition when they come together with the blockage, drainage, and loss of smell. If a constant headache is your only symptom, that likely points to something else, so it's worth talking through with your doctor.
When do doctors consider sinus surgery, and is chronic sinusitis dangerous? Surgery usually comes up when symptoms keep going despite treatments like rinses and sprays. Some clinical trials are now testing whether newer medications can reduce how often surgery is needed, and some even recruit people who are actively weighing whether to have it.
As for the danger question: chronic sinusitis isn't known to shorten life. What the research does show is the real toll it takes on quality of life, sleep, mood, and the ability to work, at a level that studies have found comparable to other major chronic diseases. If you're concerned about your own case or possible complications, that's a conversation to have with your doctor.
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