The role of biologics in chronic rhinosinusitis: a systematic review

BackgroundChronic rhinosinusitis (CRS) refractory to medical and surgical treatment is challenging. It impacts patients ’ quality of life significantly. The pathophysiology of CRS has some similarities to allergic asthma and allergic rhinitis (AR) and includes eosinophilia, T‐helper cell 2 cytokines, and local immunoglobilin E formation. Monoclonal antibody therapy has been used successfully in asthma and AR and more recently in CRS. Our was aim to systematically review the literature and identify the role of monoclonal antibodies (MAbs) in the treatment of CRS with polyps (CRSwNP) and without polyps (CRSsNP), especially with regard to comparability with current medical treatment, efficacy, and risk of comp lications. In addition, the role of surgery and biologics was evaluated.MethodsWe identified at total of 5341 relevant studies after a comprehensive database search. Six studies met the inclusion criteria, all 6 randomized, controlled trials.ResultsTreatment with omalizumab and mepolizumab demonstrated improvements in endoscopic nasal polyp score (EPS) and symptoms score in patients with CRSwNP when compared with placebo. Reslizumab reduced nasal polyp size in patients with raised intranasal interleukin ‐5 levels. Dupilumab treatment resulted in a 70% reduction in EPS compared with 20% in the placebo group (p
Source: International Forum of Allergy and Rhinology - Category: Allergy & Immunology Authors: Tags: REVIEW ARTICLE Source Type: research

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We examined the impact of mepolizumab on clinically significant exacerbations and health-related quality of life (HRQoL) in patients with severe eosinophilic asthma and upper respiratory comorbidities.
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
Atopic dermatitis (AD) is a chronic inflammatory skin disease commonly associated with other atopic conditions such as allergic rhinitis (AR). Dupilumab is approved in the USA for adults and adolescents with inadequately controlled moderate-to-severe AD; as an add-on maintenance treatment for adults and adolescents with inadequately controlled eosinophilic/oral corticosteroid-dependent asthma; and as an add-on maintenance treatment in adults with inadequately controlled chronic rhinosinusitis with nasal polyps.
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
In this ‘From Pages of Allergy Watch’ summaries focusing on rhinosinusitis, the theme of this issue of Annals, will be reviewed. The first is a post-hoc analysis of data that helps us understand the impact of dupilumab on inflammatory markers to reduce polyp size and improve smell in patients with chron ic rhinosinusitis with nasal polyps. The next is a systemic review article showing that allergic rhinitis is associated with substantial work production losses. Lastly, a review of a study using nasal allergen challenges with curettage biopsies which showed the importance of type 2 innate lymphoid c ells in the ...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Special Series Source Type: research
In this From the Pages of Allergy Watch, summaries that focus on rhinosinusitis, the theme of this issue of Annals, are reviewed. The first summary is on a post hoc analysis of data that helps us understand the effect of dupilumab on inflammatory markers to reduce polyp size and improve smell in patients with chronic rhinosinusitis with nasal polyps. The second summary is on a systemic review article that found that allergic rhinitis (AR) is associated with substantial work production losses. The third summary is a review of a study using nasal allergen challenges with curettage biopsies that emphasizes the importance of t...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Special Series Source Type: research
Conclusions: Allergic rhinitis is common comorbidity of asthma that interrelated to asthma control. Identifiable allergens could be detected AR in asthma by SPT. Therefore, reduction of allergens exposure could become preventive approach for asthma patients with AR.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
This study assesses basal serum levels of cytokines in patients with allergic rhinitis and nasal polyps prior to initiation of allergen-specific immunotherapy (ASIT).
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
Abstract IgE is the less abundant immunoglobulin isotype in serum and displays higher affinity for its cognate Fc receptor (FcεRI) than the rest of antibody isotypes. Moreover, the class switch recombination and the generation of memory responses remarkably differ between IgE and other isotypes. Importantly, class switch recombination to IgE can occur in the mucosae, preferentially through the sequential switching from IgG. Therefore, resident effector cells get rapidly sensitized, and free IgE can be found in mucosal secretions. All these aspects explain the involvement of IgE in respiratory diseases. In ...
Source: Current Opinion in Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Opin Pharmacol Source Type: research
Abstract BACKGROUND: A mometasone furoate (MF) sinus implant (1350 mcg) was evaluated in 2 randomized controlled trials (RCTs) in 400 adults with nasal polyps (NP) who were candidates for revision endoscopic sinus surgery (RESS). We conducted a pooled analysis to evaluate the efficacy of MF implant in specific subgroups of NP patients. METHODS: Pooled data from 2 RCTs for 375 patients were analyzed across prespecified subjective and objective end points through day 90. RESULTS: At day 90, patients receiving implants and MF nasal spray (MFNS) experienced significant improvements in nasal obstruction/conge...
Source: American Journal of Rhinology and Allergy - Category: ENT & OMF Authors: Tags: Am J Rhinol Allergy Source Type: research
Conclusion In Table 1, an overview is presented of the complex roles of AAs described in this review regarding the microbiome-gut-immune-brain axis in ASD. Besides behavioral deficits, people with ASD are characterized by systemic inflammation, gastrointestinal immune-related disturbances and changes in the gut microbiota composition. Moreover, differences in levels of specific AAs in various body compartments, including the intestinal tract, blood, urine and brain have been reported in patients with ASD, as well as in rodent models for ASD. This review described that specific AAs can modulate the intestinal epithelial im...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Publication date: Available online 27 March 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Marc Humbert, Jean Bousquet, Claus Bachert, Oscar Palomares, Pascal Pfister, Ioannis Kottakis, Xavier Jaumont, Simon Francis Thomsen, Nikolaos G. PapadopoulosAllergic asthma often coexists with different pathological conditions, called multimorbidities, that are mostly of allergic nature and share a common underlying inflammatory pathophysiological mechanism. Multimorbidities of allergic asthma may influence asthma control, its severity, and patients' response to treatment, and contribute to the ove...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
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