Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC Amsterdam, Amsterdam, The Netherlands.
European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium.
Allergy. 2019 Dec;74(12):2312-2319. doi: 10.1111/all.13875. Epub 2019 Jul 15.
Novel therapies such as type 2 targeting biologics are emerging treatment options for patients with chronic inflammatory respiratory diseases, fulfilling the needs of severely uncontrolled patients. The majority of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and over half of patients with asthma show a type 2 inflammatory signature in sinonasal mucosa and/or lungs. Importantly, both chronic respiratory diseases are frequent comorbidities, ensuring alleviation of both upper and lower airway pathology by systemic biological therapy. Type 2-targeting biologics such as anti-IgE, anti-IL4Rα, anti-IL5, and anti-IL5Rα have entered the market for selected pheno/endotypes of asthma patients and may soon also become available for CRSwNP patients. Given the high prevalence of chronic respiratory diseases and the high cost associated with biologics, patient selection is crucial in order to implement such therapies into chronic respiratory disease care pathways. The European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) organized a multidisciplinary Expert Board Meeting to discuss the positioning of biologics into the care pathways for CRSwNP patients with and without comorbid asthma.
新型疗法,如针对 2 型的生物制剂,正成为慢性炎症性呼吸系统疾病患者的新兴治疗选择,满足了严重控制不良患者的需求。大多数伴有鼻息肉的慢性鼻-鼻窦炎(CRSwNP)患者和一半以上的哮喘患者,其鼻窦黏膜和/或肺部均表现出 2 型炎症特征。重要的是,这两种慢性呼吸系统疾病常同时存在,通过全身生物治疗可同时缓解上、下呼吸道病变。针对 2 型的生物制剂,如抗 IgE、抗 IL4Rα、抗 IL5 和抗 IL5Rα,已被用于部分哮喘患者的表型/终末型,且可能很快也可用于 CRSwNP 患者。鉴于慢性呼吸系统疾病的高患病率和生物制剂相关的高成本,患者选择对于将此类治疗纳入慢性呼吸系统疾病的治疗途径至关重要。欧洲过敏和气道疾病研究与教育论坛(EUFOREA)组织了一次多学科专家委员会会议,讨论了将生物制剂用于伴有或不伴有合并哮喘的 CRSwNP 患者的治疗途径中的定位。