Department of Otolaryngology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
Department of Otolaryngology, Harvard Medical School, Boston, MA, USA.
Drugs. 2017 Oct;77(16):1713-1721. doi: 10.1007/s40265-017-0803-4.
Chronic rhinosinusitis (CRS) is an inflammatory sinonasal condition with multiple etiologic factors that is associated with a vast economic cost. Treatment is most frequently pharmacologic and has centered on agents that ameliorate inflammation, decrease bacterial or pathogen load, and facilitate egress of mucus or purulence from the sinonasal cavity. Nasal saline irrigations, topical nasal steroids, certain antibiotics, and systemic steroids have shown some efficacy in the management of CRS. Recently, biologic therapeutics that target specific inflammatory pathways associated with subsets of CRS have been developed and evaluated. Early data evaluating these biologic treatments suggest a potential role in treating a subset of CRS with refractory, poorly controlled disease. Additional studies are necessary to identify which patients would benefit most from biologic therapies and to assess the cost of these therapies compared with the benefit they provide. This review describes the pathophysiology of CRS and summarizes both established and novel biologic pharmacologic treatments.
慢性鼻-鼻窦炎（CRS）是一种具有多种病因的炎症性鼻-鼻窦疾病，与巨大的经济成本相关。治疗主要是药物治疗，主要集中在减轻炎症、减少细菌或病原体负荷以及促进鼻-鼻窦腔黏液或脓性分泌物排出的药物。鼻腔盐水冲洗、局部鼻腔类固醇、某些抗生素和全身类固醇在 CRS 的治疗中显示出一定的疗效。最近，针对与 CRS 亚群相关的特定炎症途径的生物治疗药物已经开发并进行了评估。早期评估这些生物治疗的研究数据表明，对于难治性、控制不佳的疾病，它们可能在治疗 CRS 的亚群中具有潜在作用。还需要更多的研究来确定哪些患者最受益于生物治疗，以及评估这些治疗的成本与它们提供的效益。本文综述了 CRS 的病理生理学，并总结了已确立和新型的生物药理学治疗方法。
