EUFOREA expert board meeting on uncontrolled severe chronic rhinosinusitis with nasal polyps (CRSwNP) and biologics: Definitions and management - 09/01/21
, Joe K. Han, MD, PhD d, Martin Wagenmann, MD, PhD e, Werner Hosemann, MD, PhD f, Stella E. Lee, MD, PhD g, Vibeke Backer, MD, PhD h, Joaquim Mullol, MD, PhD i, Philippe Gevaert, MD, PhD a, Ludger Klimek, MD, PhD j, Emanuel Prokopakis, MD, PhD k, Andrew Knill, MD, PhD l, Carlo Cavaliere, MD, PhD m, Claire Hopkins, MD, PhD n, Peter Hellings, MD, PhD oAbstract |
Uncontrolled severe chronic rhinosinusitis with nasal polyps (CRSwNP) is the most bothersome phenotype of chronic rhinosinusitis; it is typically characterized by a type 2 inflammatory reaction and by comorbidities, including asthma, nonsteroidal anti-inflammatory drug–exacerbated respiratory disease, and allergies. Here, the European Forum for Research and Education in Allergy and Airway Diseases proposes structured definitions to enable communication between clinicians and provides a practical algorithm to define type 2 inflammation in CRSwNP in daily clinical practice. A rational approach for the treatment of uncontrolled severe CRSwNP is discussed; it consists of evaluating the perspective and risks of surgery and efficacy and adverse events of biologics on the basis of currently available data. Further, possible combinations of surgery and biologics are discussed, and a rationale is provided. Here, it is of importance to adequately counsel the patient about both approaches to enable a decision-making process with an informed patient. Criteria for the selection of a biologic drug are provided, as several biologics for uncontrolled severe CRSwNP will be available in many countries within a short time. Further, suggestions for monitoring of the drug effects that support recognition of responders to the therapy and, subsequently, the decision regarding continuation or discontinuation of the biologic are proposed.
Le texte complet de cet article est disponible en PDF.Key words : Chronic rhinosinusitis, nasal polyps, endotypes, type 2 inflammation, sinus surgery, biologics, indication, patient selection
Abbreviations used : AE, CRSwNP, DBPCRS, ESS, EUFOREA, GCS, HRQoL, INCS, N-ERD, NPS
Plan
| This was an initiative of and sponsored by EUFOREA. |
|
| Disclosure of potential conflict of interest: C. Bachert reports being a speaker and member of advisory boards for Sanofi-Aventis, Regeneron, Novartis, Genentech, Glaxo, AstraZeneca, Stallergenes, ALK, Asit Biotech, Mylan, and Allakos. J. Han reports being a consultant for ALK-Abelló, AstraZeneca, Sanofi Genzyme, GlaxoSmithKline, Genentech, Intersect, Medtronic, Optinose, Novartis, and Regeneron. M. Wagenmann reports receiving personal fees and/or research grants from ALK-Abelló, Allergopharma, AstraZeneca, Bencard, Genzyme, GlaxoSmithKline, HAL Allergie, LETI Pharma, MEDA Pharma, Novartis, Regeneron, Sanofi Aventis, Stallergenes, and Teva. W. Hosemann reports being a speaker and member of advisory boards for Intersect ENT, Karl Storz, Novartis, and Sanofi-Aventis. S. Lee reports serving on an advisory board for and receiving funding from AstraZeneca, Genentech Novartis, Genzyme, GlaxoSmithKline, Sanofi, and Regeneron. V. Backer reports being a speaker and member of advisory boards for Chiesi, Sanofi-Aventis, GlaxoSmithKline, AstraZeneca, ALK, TEVA, MSD, and Novartis. J. Mullol reports being an advisory board member or speaker for ALK, AstraZeneca, Genentech, GlaxoSmithKline, Glenmark, Menarini, Mitsubishi-Tanabe, MSD, Mylan-MEDA Pharma, Novartis, Regeneron Pharmaceuticals, SANOFI-Genzyme, UCB Pharma, and Uriach Group. P. Gevaert reports being a speaker and advisory board member for Ablynx, ALK, Argenx, AstraZeneca, Genentech, Hal Allergy, Novartis, Regeneron, Roche, Sanofi-Aventis, Stallergenes-Greer, and 3NT. L. Klimek reports being a speaker and consultant for Allergy Therapeutics/Bencard, ALK-Abelló, Allergopharma, ASIT Biotech, AstraZeneca, Biomay, Boehringer Ingelheim, Stallergenes, Cytos, Curalogic, HAL, Lofarma, Mylan, Novartis, Leti, ROXALL, GlaxoSmithKline, and Sanofi-Aventis. C. Hopkins reports being an advisory board member for AstraZeneca, Sanofi-Aventis, Smith and Nephew, and Olympus. P. Hellings reports being a speaker and advisor for Sanofi, Novartis, Mylan, GlaxoSmithKline, and Stallergenes/Greer. |
Vol 147 - N° 1
P. 29-36 - janvier 2021 Retour au numéro
Article précédent
- Current insights into the genetics of food allergy
- Kanika Kanchan, Selene Clay, Haritz Irizar, Supinda Bunyavanich, Rasika A. Mathias
- The Editors’ Choice
- Zuhair K. Ballas, Associate Editors of the JACI
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?