A new experimental drug has shown significant promise in treating chronic rhinosinusitis with nasal polyps (CRSwNP), a condition affecting up to 4% of the general population. In a Phase 2 clinical trial called VIBRANT, an injectable medication called verekitug reduced nasal polyp scores by nearly two points and cut the need for sinus surgery or systemic corticosteroids by 76% compared to placebo. The findings, presented at the American Academy of Allergy Asthma & Immunology annual meeting in 2026, suggest a potential new treatment option for the millions of people whose symptoms remain uncontrolled despite existing therapies. What Is Chronic Rhinosinusitis with Nasal Polyps? Chronic rhinosinusitis with nasal polyps is a long-term inflammatory condition of the nose and sinuses marked by the growth of benign polyps. The disease causes four main symptoms that significantly impact daily life: - Runny Nose or Postnasal Drip: Excess mucus drainage down the back of the throat, often worse when lying down or in certain positions. - Nasal Congestion: Persistent blockage that makes breathing through the nose difficult, even with current treatments. - Facial Pressure and Pain: Discomfort around the sinuses, forehead, and cheeks that can worsen with weather changes or infections. - Loss of Smell and Taste: Reduced ability to enjoy food and detect odors, which can affect appetite and quality of life. The condition is surprisingly common and often undertreated. An estimated 40% of people with CRSwNP have uncontrolled disease despite available treatments like nasal corticosteroids, surgery, and newer biologic medications. The disease also frequently overlaps with asthma; research shows that over 40% of people with severe asthma also have CRSwNP, and up to 70% of people with CRSwNP also have asthma. How Does Verekitug Work Differently? Verekitug is a monoclonal antibody, a type of protein designed to target specific molecules in the body that trigger inflammation. Unlike some existing treatments that target multiple inflammatory pathways, verekitug focuses on blocking a single upstream target called the thymic stromal lymphopoietin (TSLP) receptor. TSLP is a cytokine, or signaling molecule, that acts as a key driver of the inflammatory cascade in allergic and inflammatory diseases. By blocking TSLP early in the inflammatory process, verekitug may prevent the activation of downstream inflammatory signals, including IL-4, IL-5, IL-13, IL-17, and IgE. The advantage of this approach is that a single treatment targeting TSLP may impact multiple pathological inflammatory processes across different diseases. This is why verekitug is being studied not only in CRSwNP but also in severe asthma and chronic obstructive pulmonary disease (COPD). What Did the VIBRANT Trial Show? The VIBRANT trial enrolled 81 adults with CRSwNP who were already using intranasal corticosteroids. Participants received either 100 milligrams of verekitug or placebo injected under the skin every 12 weeks for 24 weeks. The study measured several outcomes to assess how well the drug worked. The primary endpoint was the endoscopic nasal polyp score, a measurement doctors use to assess polyp size and burden by looking directly into the nasal passages. Verekitug reduced this score by 1.95 points compared to placebo, a statistically significant difference. For context, this means the drug shrank or reduced the polyps in a meaningful way that doctors could observe and measure. Beyond polyp size, the trial also measured patient-reported symptoms. Participants taking verekitug reported a reduction in nasal congestion score of 0.96 points compared to placebo, another statistically significant finding. Perhaps most importantly, verekitug reduced the need for rescue interventions. Participants on the drug were 76% less likely to require nasal polyp surgery or systemic corticosteroids compared to those on placebo. Why Does the Dosing Schedule Matter? One notable advantage of verekitug is its dosing frequency. The drug is administered every 12 weeks, or four times per year, compared to currently available biologic treatments for CRSwNP that require more frequent dosing. This less-frequent schedule could improve patient adherence and reduce the burden of treatment, since fewer injections mean fewer doctor visits and less disruption to daily life. "The magnitude of improvement observed with verekitug across both analytical approaches, along with the previously reported reduction in rescue interventions, suggests the potential for meaningful benefit for people living with chronic rhinosinusitis with nasal polyps. Additionally, the efficacy outcomes we observed in VIBRANT, combined with the every 12-week dosing interval, suggest that verekitug could represent a valuable new treatment option for people living with this challenging condition," said Joseph Han, MD, Professor in the Department of Otolaryngology & Head and Neck Surgery and Chief for the Division of Allergy at Old Dominion University. Joseph Han, MD, Professor of Otolaryngology & Head and Neck Surgery and Chief for the Division of Allergy at Old Dominion University What About Safety? The trial found that verekitug was generally well tolerated with a favorable safety profile. No serious adverse events were observed in the study, which is an important finding for a drug intended for long-term use in a chronic condition. This safety data provides reassurance that the drug does not appear to cause major harm, though longer-term studies will continue to monitor for any delayed effects as the drug advances through later-stage testing. What Happens Next? Based on the positive results from VIBRANT, Upstream Bio, the company developing verekitug, has begun planning Phase 3 trials, which are the final stage of testing before seeking regulatory approval. The company intends to initiate registrational trials in both CRSwNP and severe asthma following planned discussions with regulatory authorities. Phase 3 trials are typically larger and longer than Phase 2 studies, involving hundreds of participants and lasting several months to years, to confirm that the drug works as expected and remains safe in a broader population. "The strong results in clinical effect we saw in these additional analyses are an important validation of verekitug's impact on endpoints that take into consideration the use of rescue medication, which was substantially reduced with verekitug treatment in VIBRANT. As this approach more closely aligns with that used in other recent studies of agents in CRSwNP, it also enhances our understanding of verekitug's potential to add to the existing armamentarium for this serious disease," stated Aaron Deykin, MD, Chief Medical Officer and Head of Research & Development at Upstream Bio. Aaron Deykin, MD, Chief Medical Officer and Head of Research & Development at Upstream Bio Why This Matters for Patients For the millions of people living with uncontrolled CRSwNP, the emergence of new treatment options is significant. Current therapies, including nasal corticosteroids, surgery, and existing biologic medications, do not work well enough for many patients. The fact that verekitug reduced the need for surgery by 76% is particularly meaningful, since sinus surgery carries risks and often requires recovery time. A medication that can control symptoms and reduce the need for invasive procedures could substantially improve quality of life and reduce healthcare costs associated with repeated surgeries and emergency interventions. The overlap between CRSwNP and severe asthma also suggests that a single treatment targeting TSLP could benefit patients with both conditions, potentially simplifying their treatment regimen. As verekitug moves into Phase 3 trials, patients and healthcare providers will be watching closely to see whether these promising early results hold up in larger, more diverse populations and whether the drug eventually becomes available as a treatment option.
