欧洲过敏和气道疾病研究和教育论坛关于治疗伴或不伴哮喘的慢性鼻窦炎鼻息肉的生物制剂的共识
2020/09/17
摘要
2型靶向生物制剂等新的疗法，是治疗慢性炎症性呼吸道疾病新兴的选择，满足了严重未控制患者的需要。大多数慢性鼻窦炎伴鼻息肉（CRSwNP）患者和半数以上哮喘患者在鼻腔黏膜和/或肺部表现出2型炎症特征。重要的是，这两种慢性呼吸系统疾病都是常见的共患病，通过系统的生物治疗使得上下呼吸道病理得以缓解。抗IgE、抗IL4Rα、抗IL 5和抗IL 5Rα等2型靶向生物制剂，已应用到了哮喘患者表型/内型的选择中，并且可能很快也可用于CRSwNP患者。鉴于慢性呼吸系统疾病的高发病率和生物制剂治疗的高成本，成功将此类疗法应用于慢性呼吸道疾病治疗途径中的患者选择是至关重要的。欧洲过敏和气道疾病研究和教育论坛（EUFOREA）组织了一次多学科专家委员会会议，讨论了生物制剂在CRSwNP合并或合并哮喘的患者治疗途径中的定位。
EUFOREA consensus on biologics for CRSwNP with or without asthma.
Wytske J Fokkens ,Valerie Lund ,Claus Bachert ,Joaquim Mullol ,Leif Bjermer ,Jean Bousquet ,Giorgio W Canonica ,Lauren Deneyer ,Martin Desrosiers ,Zuzana Diamant ,Joseph Han ,Enrico Heffler ,Claire Hopkins ,Roger Jankowski ,Guy Joos ,Andrew Knill ,Jivianne Lee ,Stella E Lee ,Gert Mariën ,Benoit Pugin ,Brent Senior ,Sven F Seys ,Peter W Hellings.
Abstract
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.
2型靶向生物制剂等新的疗法，是治疗慢性炎症性呼吸道疾病新兴的选择，满足了严重未控制患者的需要。大多数慢性鼻窦炎伴鼻息肉（CRSwNP）患者和半数以上哮喘患者在鼻腔黏膜和/或肺部表现出2型炎症特征。重要的是，这两种慢性呼吸系统疾病都是常见的共患病，通过系统的生物治疗使得上下呼吸道病理得以缓解。抗IgE、抗IL4Rα、抗IL 5和抗IL 5Rα等2型靶向生物制剂，已应用到了哮喘患者表型/内型的选择中，并且可能很快也可用于CRSwNP患者。鉴于慢性呼吸系统疾病的高发病率和生物制剂治疗的高成本，成功将此类疗法应用于慢性呼吸道疾病治疗途径中的患者选择是至关重要的。欧洲过敏和气道疾病研究和教育论坛（EUFOREA）组织了一次多学科专家委员会会议，讨论了生物制剂在CRSwNP合并或合并哮喘的患者治疗途径中的定位。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Allergy, 2019 Dec;74(12):2312-2319. doi: 10.1111/all.13875. Epub 2019 Jul 15.)
(Allergy, 2019 Dec;74(12):2312-2319. doi: 10.1111/all.13875. Epub 2019 Jul 15.)
EUFOREA consensus on biologics for CRSwNP with or without asthma.
Wytske J Fokkens ,Valerie Lund ,Claus Bachert ,Joaquim Mullol ,Leif Bjermer ,Jean Bousquet ,Giorgio W Canonica ,Lauren Deneyer ,Martin Desrosiers ,Zuzana Diamant ,Joseph Han ,Enrico Heffler ,Claire Hopkins ,Roger Jankowski ,Guy Joos ,Andrew Knill ,Jivianne Lee ,Stella E Lee ,Gert Mariën ,Benoit Pugin ,Brent Senior ,Sven F Seys ,Peter W Hellings.
Abstract
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.
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