Guy's and St Thomas' Hospitals, London, UK.
Guy's and Hospitals, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Clin Otolaryngol. 2021 Sep;46(5):1037-1043. doi: 10.1111/coa.13779. Epub 2021 Apr 22.
We set out to create Consensus Guidelines, based on current evidence and relative risks of adverse effects and the costs of different treatments, which reflect the views of the British Rhinological Society (BRS) Council on where the use of biologics should be positioned within treatment pathways for CRSwNP, specifically in the setting of the National Health Service (NHS).
An expert panel of 16 members was assembled. A review of the literature and evidence synthesis was undertaken and circulated to the panel. We used the RAND/UCLA methodology with a multi-step process to make recommendations on the use of biologics.
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Recommendations were made, based on underlying disease severity, prior treatments and co-morbidities. A group of patients for whom biologics were considered an appropriate treatment option for CRSwNP was defined.
Although biologics are not currently available for the treatment of CRSwNP, the BRS Council have defined a group of patients who have higher rates of "failure" with current treatment pathways, higher resource use and are more likely to suffer with uncontrolled symptoms. We would urge NICE to consider approval of biologics for such indications without applying further restrictions on use.
我们制定了共识指南，基于当前的证据和不良反应的相对风险以及不同治疗方法的成本，反映了英国鼻科学会（BRS）理事会对生物制剂在慢性鼻窦炎伴鼻息肉（CRSwNP）治疗途径中的定位的看法，特别是在国民保健制度（NHS）的背景下。
召集了一个由 16 名成员组成的专家小组。对文献进行了审查和综合分析，并分发给专家组。我们使用 RAND/UCLA 方法，采用多步骤流程，就生物制剂的使用提出建议。
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根据潜在疾病严重程度、先前的治疗和合并症，提出了建议。定义了一组被认为是 CRSwNP 生物制剂治疗的合适选择的患者。
尽管生物制剂目前尚未用于治疗 CRSwNP，但 BRS 理事会已经确定了一组患者，他们在目前的治疗途径中“失败”的几率更高，资源利用更高，更有可能出现症状失控的情况。我们强烈敦促 NICE 在不进一步限制使用的情况下，考虑批准这些适应症的生物制剂。
