What are the recommended first-line treatments for adults diagnosed with nasal polyps in primary care?

First-line treatment for adults diagnosed with nasal polyps in primary care is the use of topical intranasal corticosteroids. These medications help reduce inflammation and polyp size, improving nasal airflow and symptoms.

Initial management typically involves prescribing a regular regimen of intranasal corticosteroid sprays, which are effective in controlling symptoms and may reduce the need for surgery.

In cases where allergic rhinitis coexists, antihistamines may be considered adjunctively, but corticosteroids remain the cornerstone of treatment.

Referral to an ear, nose, and throat (ENT) specialist should be considered if symptoms persist despite optimal medical therapy or if anatomical obstruction is suspected.

Emerging treatments such as biological therapies are being explored but are not currently first-line in primary care.

This approach aligns with UK clinical guidance on managing nasal obstruction and rhinitis, which recommends topical nasal corticosteroids as initial therapy for nasal polyps and related nasal inflammation ¹. Evidence-based literature supports the efficacy of intranasal corticosteroids in reducing polyp size and symptom burden, emphasizing their role as the mainstay of treatment (Bachert, 2011). Expert opinion also highlights the potential for biological treatments in refractory cases but confirms corticosteroids as first-line (Al-Ahmad et al., 2022).