Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update
Introduction: Biologics targeting type 2 inflammation have revolutionized the way we treat patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Particularly in severe and difficult-to-control cases, these drugs have provided a new reality for these patients, allowing for the effective an...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-05-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869424000090 |
| _version_ | 1797304598883467264 |
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| author | Wilma T. Anselmo-Lima Fabrizio R. Romano Edwin Tamashiro Renato Roithmann Vanessa R.P. Dinarte Otavio B. Piltcher Marcel M. Miyake Marco A. Fornazieri Marcio Nakanishi Thiago F.P. Bezerra Ricardo L.L. Dolci João F. Mello Jr Marcus M. Lessa Richard L. Voegels Eduardo M. Kosugi Eulalia Sakano Fabiana C.P. Valera |
| author_facet | Wilma T. Anselmo-Lima Fabrizio R. Romano Edwin Tamashiro Renato Roithmann Vanessa R.P. Dinarte Otavio B. Piltcher Marcel M. Miyake Marco A. Fornazieri Marcio Nakanishi Thiago F.P. Bezerra Ricardo L.L. Dolci João F. Mello Jr Marcus M. Lessa Richard L. Voegels Eduardo M. Kosugi Eulalia Sakano Fabiana C.P. Valera |
| author_sort | Wilma T. Anselmo-Lima |
| collection | DOAJ |
| description | Introduction: Biologics targeting type 2 inflammation have revolutionized the way we treat patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Particularly in severe and difficult-to-control cases, these drugs have provided a new reality for these patients, allowing for the effective and safe treatment of extensive diseases that were not completely managed with the typical strategy of surgery and topical medications. Objectives: The experience achieved with the approval of these medications by ANVISA for use in CRSwNP and the knowledge obtained regarding outcomes, adverse effects, and the ideal patient profile prompted the update of the previously published guideline, with a detailed review of the most recent scientific literature, the personal experiences of experts, and the adaptation to the reality of the Brazilian healthcare system, both public and private. Results: We proposed a new eligibility criterion for biologics in patients with CRSwNP based on four pillars of indication: the impact of the disease on the patient’s life, whether in the presence of specific symptoms or in overall quality of life; the extent of sinonasal disease; the presence of type 2 comorbidities, considering other associated diseases that may also benefit from anti-T2 biologics, and the presence of biomarkers to define type 2 inflammation, especially those associated with worse disease prognoses. Conclusions: This innovative and pioneering method has two major advantages. First, it ensures a comprehensive evaluation of patients; second, it is flexible, as advancements in our understanding of the disease and changes in cost-effectiveness can be addressed by simply adjusting the required score for indication, without the need to modify the entire evaluation scheme. |
| first_indexed | 2024-03-08T00:12:45Z |
| format | Article |
| id | doaj.art-08d9fa043ae84f8796b50bc77af694aa |
| institution | Directory Open Access Journal |
| issn | 1808-8694 |
| language | English |
| last_indexed | 2024-03-08T00:12:45Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj.art-08d9fa043ae84f8796b50bc77af694aa2024-02-17T06:37:22ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942024-05-01903101394Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 updateWilma T. Anselmo-Lima0Fabrizio R. Romano1Edwin Tamashiro2Renato Roithmann3Vanessa R.P. Dinarte4Otavio B. Piltcher5Marcel M. Miyake6Marco A. Fornazieri7Marcio Nakanishi8Thiago F.P. Bezerra9Ricardo L.L. Dolci10João F. Mello Jr11Marcus M. Lessa12Richard L. Voegels13Eduardo M. Kosugi14Eulalia Sakano15Fabiana C.P. Valera16Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil; Corresponding author.Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Universidade de São Paulo (FMRP-USP), Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, BrazilUniversidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, BrazilUniversidade Luterana do Brasil, Canoas, RS, BrazilFaculdade de Medicina de Marília (FAMEMA), Marilia, SP, BrazilFaculdade de Medicina da Universidade Federal do Rio Grande do Sul (FAMED-UFRGS), Departamento de Oftalmologia e Otorrinolaringologia, Porto Alegre, RS, BrazilUniversidade de São Paulo (FMRP-USP), Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil; Santa Casa de Misericórdia, Hospital de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, BrazilUniversidade Estatual de Londrina, Londrina, PR, Brazil; Pontifícia Universidade Católica do Paraná (PUCPR), Câmpus Londrina, Londrina, PR, BrazilUniversidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação, Brasilia, DF, BrazilUniversidade Federal de Pernambuco, Recife, PE, BrazilSanta Casa de São Paulo, São Paulo, SP, BrazilFaculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilFaculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, BrazilFaculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilUniversidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade Estadual Paulista, Faculdade de Ciências Médicas, Departamento de Oftalmologia/Otorrinolaringologia, Campinas, SP, BrazilUniversidade de São Paulo (FMRP-USP), Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, BrazilIntroduction: Biologics targeting type 2 inflammation have revolutionized the way we treat patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Particularly in severe and difficult-to-control cases, these drugs have provided a new reality for these patients, allowing for the effective and safe treatment of extensive diseases that were not completely managed with the typical strategy of surgery and topical medications. Objectives: The experience achieved with the approval of these medications by ANVISA for use in CRSwNP and the knowledge obtained regarding outcomes, adverse effects, and the ideal patient profile prompted the update of the previously published guideline, with a detailed review of the most recent scientific literature, the personal experiences of experts, and the adaptation to the reality of the Brazilian healthcare system, both public and private. Results: We proposed a new eligibility criterion for biologics in patients with CRSwNP based on four pillars of indication: the impact of the disease on the patient’s life, whether in the presence of specific symptoms or in overall quality of life; the extent of sinonasal disease; the presence of type 2 comorbidities, considering other associated diseases that may also benefit from anti-T2 biologics, and the presence of biomarkers to define type 2 inflammation, especially those associated with worse disease prognoses. Conclusions: This innovative and pioneering method has two major advantages. First, it ensures a comprehensive evaluation of patients; second, it is flexible, as advancements in our understanding of the disease and changes in cost-effectiveness can be addressed by simply adjusting the required score for indication, without the need to modify the entire evaluation scheme.http://www.sciencedirect.com/science/article/pii/S1808869424000090BiologicalsMonoclonal antibodiesChronic rhinosinusitisNasal polyp |
| spellingShingle | Wilma T. Anselmo-Lima Fabrizio R. Romano Edwin Tamashiro Renato Roithmann Vanessa R.P. Dinarte Otavio B. Piltcher Marcel M. Miyake Marco A. Fornazieri Marcio Nakanishi Thiago F.P. Bezerra Ricardo L.L. Dolci João F. Mello Jr Marcus M. Lessa Richard L. Voegels Eduardo M. Kosugi Eulalia Sakano Fabiana C.P. Valera Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update Brazilian Journal of Otorhinolaryngology Biologicals Monoclonal antibodies Chronic rhinosinusitis Nasal polyp |
| title | Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update |
| title_full | Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update |
| title_fullStr | Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update |
| title_full_unstemmed | Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update |
| title_short | Brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps ‒ 2024 update |
| title_sort | brazilian guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps 2024 update |
| topic | Biologicals Monoclonal antibodies Chronic rhinosinusitis Nasal polyp |
| url | http://www.sciencedirect.com/science/article/pii/S1808869424000090 |
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