慢性鼻窦炎伴鼻息肉的指示性生物制剂(CRSwNP)

Ludger Klimek, Ulrike Förster-Ruhrmann, Achim G. Beule, Adam M. Chaker, Jan Hagemann, Felix Klimek, Ingrid Casper, Tilman Huppertz, Thomas K. Hoffmann, Stefan Dazert, Thomas Deitmer, Heidi Olze, Sebastian Strieth, Holger Wrede, Wolfgang Schlenter, Hans-Jürgen Welkoborsky, Barbara Wollenberg, Christoph Bergmann, Mandy Cuevas, Caroline Beutner, Moritz Gröger,  Sven Becker
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引用次数: 3

摘要

摘要背景慢性鼻窦炎伴鼻息肉(CRSwNP)是一种鼻旁粘膜炎症性疾病,主要以2型炎症为特征。三种抗体(dupilumab、omalizumab和mepolizumab)现已被批准用于治疗严重的CRSwNP。在治疗过程中记录疾病的严重程度是至关重要的。方法检索Medline、PubMed、国家和国际试验与指南登记册以及Cochrane图书馆的文献,分析CRSwNP的免疫学,并确定杜匹单抗、奥马珠单抗和美波利珠单抗对该疾病的疗效证据。这导致我们的作者小组编写了3篇立场论文,这些论文构成了本综述的基础。结果根据国际文献中的信息,一个专家小组提出了在德国医疗保健系统中使用dupilumab、omalizumab和mepolizumab治疗CRSwNP的建议。结论dupilumab、omalizumab和mepolizumab被批准用于18岁及以上患有CRSwNP的患者,作为鼻内皮质类固醇的附加治疗,而对于Dupilumb和mepolizumab,全身皮质类固醇和/或手术治疗不能实现充分的疾病控制。当鼻内皮质类固醇治疗不能充分控制疾病时,需要使用奥马珠单抗进行治疗。根据我们的作者小组已经发表的关于这一主题的立场文件,为德国医疗保健系统中的使用提供了专门的文件建议。
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Indicating biologics for chronic rhinosinusitis with nasal polyps (CRSwNP)

Summary

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP), an inflammatory disease of the paranasal mucosa, is primarily characterized by type 2 inflammation. Three antibodies (dupilumab, omalizumab, and mepolizumab) are now approved for the treatment of severe CRSwNP. Documentation of disease severity during the course of treatment is essential.

Methods

A literature search of Medline, PubMed, and the national and international trial and guideline register, and the Cochrane Library was performed to analyze the immunology of CRSwNP and determine the evidence for the effect of dupilumab, omalizumab, and mepolizumab in this disease. This has resulted in 3 position papers prepared by our group of authors, which form the basis of this summarizing review.

Results

Based on the information from the international literature, recommendations for the use of dupilumab, omalizumab, and mepolizumab in CRSwNP in the German health care system are given by an expert panel.

Conclusion

Dupilumab, omalizumab, and mepolizumab are approved for patients 18 years of age and older with CRSwNP as add-on therapy to intranasal corticosteroids when, for dupilumab and mepolizumab, therapy with systemic corticosteroids and/or surgery does not achieve sufficient disease control. Therapy with omalizumab is indicated when therapy with intranasal corticosteroids does not result in sufficient disease control. Dedicated recommendations for the documentation of the use in the German health care system are given, which are based on the position papers of our author group already published on this topic.

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来源期刊
Allergo Journal International
Allergo Journal International Medicine-Immunology and Allergy
CiteScore
4.60
自引率
0.00%
发文量
31
期刊介绍: Allergo Journal International is the official Journal of the German Society for Applied Allergology (AeDA) and the Austrian Society for Allergology and Immunology (ÖGAI). The journal is a forum for the communication and exchange of ideas concerning the various aspects of allergy (including related fields such as clinical immunology and environmental medicine) and promotes German allergy research in an international context. The aim of Allergo Journal International is to provide state of the art information for all medical and scientific disciplines that deal with allergic, immunological and environmental diseases. Allergo Journal International publishes original articles, reviews, short communications, case reports, and letters to the editor. The articles cover topics such as allergic, immunological and environmental diseases, the latest developments in diagnosis and therapy as well as current research work concerning antigens and allergens and aspects related to occupational and environmental medicine. In addition, it publishes clinical guidelines and position papers approved by expert panels of the German, Austrian and Swiss Allergy Societies. All submissions are reviewed in single-blind fashion by at least two reviewers. Originally, the journal started as a German journal called Allergo Journal back in 1992. Throughout the years, English articles amounted to a considerable portion in Allergo Journal. This was one of the reasons to extract the scientific content and publish it in a separate journal. Hence, Allergo Journal International was born and now is the international continuation of the original German journal. Nowadays, all original content is published in Allergo Journal International first. Later, selected manuscripts will be translated and published in German and included in Allergo Journal.
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