Chinese Expert Consensus on the Use of Biologics in Patients with Chronic Rhinosinusitis (2022, Zhuhai)
Year: 2023
Type: article
Abstract: BACKGROUND: Chronic rhinosinusitis (CRS) is a common inflammatory disease in otolaryngology, mainly manifested as nasal congestion, nasal discharge, facial pain/pressure, and smell disorder. CRS with nasal polyps (CRSwNP), an important phenotype of CRS, has a high recurrence rate even after receiving corticosteroids and/or functional endoscopic sinus surgery. In recent years, clinicians have focused on the application of biological agents in CRSwNP. However, it has not reached a consensus on the timing and selection of biologics for the treatment of CRS so far. SUMMARY: We reviewed the previous studies of biologics in CRS and summarized the indications, contraindications, efficacy assessment, prognosis, and adverse effects of biologics. Also, we evaluated the treatment response and adverse reactions of dupilumab, omalizumab, and mepolizumab in the management of CRS and made recommendations. KEY MESSAGES: Dupilumab, omalizumab, and mepolizumab have been approved for the treatment of CRSwNP by the US Food and Drug Administration. Type 2 and eosinophilic inflammation, need for systemic steroids or contraindication to systemic steroids, significantly impaired quality of life, anosmia, and comorbid asthma are required for the use of biologics. Based on current evidence, dupilumab has the prominent advantage in improving quality of life and reducing the risk of comorbid asthma in CRSwNP among the approved monoclonal antibodies. Most patients tolerate biological agents well in general with few major or severe adverse effects. Biologics have provided more options for severe uncontrolled CRSwNP patients or patients who refuse to have surgery. In the future, more novel biologics will be assessed in high-quality clinical trials and applied clinically.
Source: ORL
DOI: 10.1159/000529918
Authors: Hai-yu Hong, Teng-yu Chen, Qin-tai Yang, Yue-qi Sun, Feng-hong Chen, Hong-fei Lou, Hong-tian Wang, Rui-li Yu, Yun-fang An, Feng Liu, Tian-sheng Wang, Mei-ping Lu, Qian-hui Qiu, Xiang-dong Wang, Jian-jun Chen, Cui-da Meng, Zhi-hai Xie, Juan Meng, Ming Zeng, Cheng-li Xu, Ying Wang, Yu-cheng Yang, Wei-tian Zhang, Jun Tang, Yan-li Yang, Rui Xu, Guo-dong Yu, Zhao-hui Shi, Xin Wei, Hui-ping Ye, Ya-nan Sun, Shao-qing Yu, Tian-hong Zhang, Jun Yong, Wei Hang, Yuan-teng Xu, Yu Xu, Guo-lin Tan, Na Sun, Gui Yang, You-jin Li, Jing Ye, Ke-jun Zuo, Li-qiang Zhang, Xue-yan Wang, An-ni Yang, Ying-xiang Xu, Wei Liao, Yun-ping Fan, Hua-bin Li
Institutions: Fifth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Third Affiliated Hospital of Sun Yat-sen University, Harbin Medical University, The Seventh Affiliated Hospital of Sun Yat-sen University, Second Affiliated Hospital of Harbin Medical University, The First Affiliated Hospital, Sun Yat-sen University, Shanghai Medical College of Fudan University, Fudan University, Eye & ENT Hospital of Fudan University, Capital Medical University, Beijing Shijitan Hospital, Shanxi Medical University, Second Hospital of Shanxi Medical University, West China Hospital of Sichuan University, Third Xiangya Hospital, Jiangsu Province Hospital, Guangdong Provincial People's Hospital, Beijing Tongren Hospital, Huazhong University of Science and Technology, Jilin University, Central South University, Xiangya Hospital Central South University, Tongji Hospital, Guangxi Medical University, Zhengzhou University, First Affiliated Hospital of Zhengzhou University, Kunming Medical University, The First Hospital of Kunming, First Affiliated Hospital of Kunming Medical University, The Affiliated Yongchuan Hospital of Chongqing Medical University, Shanghai Jiao Tong University, Shanghai Sixth People's Hospital, First People's Hospital of Foshan, Affiliated Hospital of Guizhou Medical University, Guizhou Provincial People's Hospital, Tongji University, First Affiliated Hospital of Harbin Medical University, Xinjiang Medical University, First Affiliated Hospital of Xinjiang Medical University, Tianjin Huanhu Hospital, First Affiliated Hospital of Fujian Medical University, Renmin Hospital of Wuhan University, Huadong Hospital, Longgang Central Hospital, Shanghai Children's Medical Center, Nanchang University, First Affiliated Hospital of Nanchang University, Qilu Hospital of Shandong University
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4362636083