Current Treatment Options
Recurrent Respiratory Papillomatosis is a challenging condition to manage due to the recurrent nature of the papillomas.
There is currently one FDA-approved therapy (PAPZIMEOS) specifically for the treatment of RRP in adults. Another potential non-surgical treatment option has been submitted to the FDA for review sometime in 2026.
CURRENT TREATMENT OPTIONS
Microsurgical excision: This is the most common treatment, where the papillomas are surgically removed under general anesthesia. Techniques include using a CO2 laser, microdebrider, or cold steel instruments.
Laser therapy: Various lasers, such as the CO2 laser and Potassium Titanyl Phosphate (KTP) laser, are used to remove papillomas. Pulse dye laser therapy is also being evaluated for its effectiveness.
Antiviral medications: Medications like cidofovir have been used to reduce the recurrence of papillomas. However, their effectiveness can vary.
Interferon therapy: This treatment aims to boost the immune system to fight the HPV virus, though it is less commonly used because of its side effects.
Photodynamic therapy: This involves using a photosensitizing agent and light to destroy papillomas. It is still under investigation.
Vaccination: The HPV vaccine can prevent the initial infection with HPV types 6 and 11, which cause RRP. It is recommended for children and young adults.
Voice therapy: This helps patients manage voice changes and improve vocal function.
Regular monitoring: Frequent follow-ups with an ENT specialist are needed to monitor and manage the condition.
Adjunct Therapies
Adjunct therapies for Recurrent Respiratory Papillomatosis are used alongside primary treatments to help manage the condition more effectively. Here are some of the current adjunct therapies:
- DIM: This is a compound derived from the digestion of indole-3-carbinol, found in cruciferous vegetables like broccoli and cabbage. It is believed to help reduce estrogen-sensitive growths, including RRP.
- Usage: Often taken as a dietary supplement, DIM’s effectiveness in RRP is still under research, and results can vary.
- Cidofovir: This antiviral medication works by inhibiting the replication of DNA viruses.
- Usage: Administered intralesionally (directly into the papillomas) after surgical removal of the growths. It has shown some success in reducing recurrence.
- Bevacizumab: This monoclonal antibody inhibits vascular endothelial growth factor, which is involved in tumor growth.
- Usage: Can be administered intralesionally or intravenously. It has shown promise in reducing the size and recurrence of papillomas.
- Interferons: These are proteins that boost the immune system’s response to viruses.
- Usage: Less commonly used due to side effects, but it can be an option for some patients.
- Gardasil: This vaccine protects against HPV types 6 and 11, which cause RRP.
- Usage: While primarily used for prevention, there is ongoing research into its potential therapeutic benefits for existing RRP cases.
- Photodynamic therapy: This therapy involves using a photosensitizing agent and light to destroy papillomas.
- Usage: Still under investigation, this treatment offers a non-surgical option for managing RRP.
- Interferons: These are proteins that boost the immune system’s response to viruses.
- Usage: Less commonly used due to side effects, but it can be an option for some patients.
These adjunct therapies are often used in combination with primary surgical treatments to help manage RRP. It’s important to discuss these options with your healthcare provider to determine the best approach for your specific case.
Resources
- Recurrent Respiratory Papillomatosis: Symptoms & Treatment
- Treatment of RRP – THE VOICE FOUNDATION
- Recurrent Respiratory Papillomatosis (RRP) – Massachusetts General Hospital
- Recurrent Respiratory Papillomatosis – THE VOICE FOUNDATION
- Bevacizumab as treatment option for recurrent respiratory papillomatosis: a systematic review
