欧洲专家对重度嗜酸性粒细胞性哮喘和伴有鼻息肉的慢性鼻-鼻窦炎的共识：海外德尔菲研究结果
Consensus from European experts on severe eosinophilic asthma and chronic rhinosinusitis with nasal polyps: Results from the OverSEA Delphi study.
作者信息
Bachert Claus, Brusselle Guy, Castillo Vizuete José Antonio, Dávila Ignacio, Laudien Martin, Seccia Veronica, Schmid-Grendelmeier Peter, Vultaggio Alessandra, Kallinikou Konstantina, Walrave Laura, Klimek Ludger
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery and the German Center of Diseases of the Upper Airway, University Hospital Münster, Münster, and the Department of Otorhinolaryngology, First Affiliated Hospital of Sun Yat-sen University, International Airway Research Center, Guangzhou, China.
Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
出版信息
J Allergy Clin Immunol Glob. 2025 Jul 3;4(4):100529. doi: 10.1016/j.jacig.2025.100529. eCollection 2025 Nov.
BACKGROUND
Managing patients with severe asthma with an eosinophilic phenotype (SEA) with comorbid respiratory conditions such as chronic rhinosinusitis with nasal polyps (CRSwNP) continues to encounter significant challenges and lack of coordinated management among treating physicians.
OBJECTIVE
The OverSEA study aims to provide insights into current clinical practices and formulate recommendations for managing these patients.
METHODS
The two-round Delphi survey, conducted March-June 2023, was developed by a multidisciplinary 11-member Scientific Committee including pulmonologists, allergists, and ear, nose and throat specialists, and involved 205 experts from these specialties across 8 European countries. Consensus was defined as ≥70% agreement. Topics covered included the initial assessment, treatment, follow-up, and multidisciplinary management of patients with SEA and CRSwNP.
RESULTS
There was a consensus that evaluating for CRSwNP (88%), allergic rhinitis (79%), chronic rhinosinusitis without nasal polyps (77%), and aspirin/nonsteroidal anti-inflammatory-exacerbated respiratory disease (71%) is crucial for diagnosing upper respiratory tract comorbidities in patients with SEA. The necessity of a multidisciplinary approach for all stages of disease management (diagnosis, 82%; treatment decision-making, 83%, follow-up, 79%), and the usefulness of biologics in simultaneously managing asthma and CRSwNP symptoms (87%) were emphasized.
CONCLUSION
The OverSEA study is the largest European initiative providing recommendations for optimizing the management of patients with SEA and comorbid CRSwNP. It underscores the importance of evaluating patients with SEA for comorbid upper airways diseases, particularly CRSwNP, and promotes a multidisciplinary approach, encouraging pulmonologists, allergists, and otorhinolaryngologists to collaborate closely to streamline patient diagnosis, follow-up, and treatment decisions.
背景
管理患有嗜酸性粒细胞性表型严重哮喘（SEA）且合并慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）等呼吸系统疾病的患者，仍然面临重大挑战，且治疗医生之间缺乏协调管理。
目的
“超越SEA”（OverSEA）研究旨在深入了解当前临床实践，并为管理这些患者制定建议。
方法
2023年3月至6月进行了两轮德尔菲调查，由一个由11名成员组成的多学科科学委员会开展，成员包括肺病学家、过敏症专科医生以及耳鼻喉科专家，共有来自8个欧洲国家的205名这些专业领域的专家参与。共识定义为达成≥70%的一致意见。涵盖的主题包括SEA和CRSwNP患者的初始评估、治疗、随访以及多学科管理。
结果
达成的共识是，评估CRSwNP（88%）、过敏性鼻炎（79%）、不伴有鼻息肉的慢性鼻-鼻窦炎（77%）以及阿司匹林/非甾体抗炎药加重的呼吸系统疾病（71%）对于诊断SEA患者的上呼吸道合并症至关重要。强调了在疾病管理的所有阶段采用多学科方法的必要性（诊断阶段，82%；治疗决策阶段，83%；随访阶段，79%），以及生物制剂在同时管理哮喘和CRSwNP症状方面的有效性（87%）。
结论
“超越SEA”研究是欧洲最大的一项为优化SEA合并CRSwNP患者管理提供建议的倡议。它强调了评估SEA患者合并上气道疾病，特别是CRSwNP的重要性，并倡导多学科方法，鼓励肺病学家、过敏症专科医生和耳鼻喉科医生密切合作，以简化患者诊断、随访和治疗决策。
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