About Recurrent Respiratory Papillomatosis
RRP is caused by 2 low-risk types of human papillomavirus, HPV 6 and HPV 11, the same types that cause genital warts. The virus infects the lining of the airway and produces benign growths called papillomas, most often on the vocal cords. They can spread down the windpipe and, rarely, into the lungs, and in a small number of patients they turn cancerous.
The growths are removed with surgery, using a laser or a microdebrider, but the virus stays in the surrounding tissue and the papillomas grow back. Some patients need surgery every few weeks, and some have had dozens or even hundreds of procedures over their lifetime. In severe cases a tracheostomy keeps the airway open. Doctors have added drugs such as cidofovir and, for severe or lung disease, the cancer drug bevacizumab, with mixed results.
In August 2025 the FDA approved Papzimeos (zopapogene imadenovec), an immunotherapy that trains the immune system to attack HPV 6 and 11 infected cells, as the first treatment for adults with RRP. In its pivotal trial, 51% of adults needed no surgery for 12 months after treatment.
Common Symptoms of Recurrent Respiratory Papillomatosis
Recognizing the signs of Recurrent Respiratory Papillomatosis early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Hoarseness or a changing voice, the most common symptom
- Noisy breathing, especially when breathing in
- Shortness of breath or trouble breathing as growths narrow the airway
- Chronic cough
- Trouble swallowing
- In children, symptoms that are often mistaken for asthma or chronic bronchitis
Who Recurrent Respiratory Papillomatosis Affects
RRP has 2 forms. Juvenile-onset RRP usually appears in early childhood; in a CDC study of 576 US children born 2004 to 2013, the median age at diagnosis was 3.4 years, and the virus is thought to pass from mother to baby during birth. Adult-onset RRP usually starts in adulthood and is thought to spread through sexual contact. Symptoms tend to be more severe in children.
The childhood form is becoming rarer as HPV vaccination spreads. In the US, the number of new cases per 100,000 births fell from 2.0 among children born in 2004 to 2005 to 0.5 among those born in 2012 to 2013, and Australia recorded a similar drop after starting school-based HPV vaccination.
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FDA-Approved Treatments for Recurrent Respiratory Papillomatosis
There is currently 1 FDA-approved medication for Recurrent Respiratory Papillomatosis. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.
Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.
Help Paying for Recurrent Respiratory Papillomatosis Treatment
Charity funds and drugmaker programs for Recurrent Respiratory Papillomatosis, checked at the source. Pick your insurance to see what fits.
Side Effect Explorer
Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.
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Diagnosis and Testing
Caused by infection with HPV types 6 and 11, not by an inherited gene change.
Trusted Recurrent Respiratory Papillomatosis Resources
Reputable organizations and medical references for learning more about Recurrent Respiratory Papillomatosis, including disease registries, foundation resources, and clinical guidelines.