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Monitoring mepolizumab treatment in chronic rhinosinusitis with nasal polyps (CRSwNP): Discontinue, change, continue therapy?
Klimek, Ludger; Förster-Ruhrmann, Ulrike; Olze, Heidi; Beule, Achim G; Chaker, Adam M; Hagemann, Jan; Huppertz, Tilman; Hoffmann, Thomas K; Dazert, Stefan; Deitmer, Thomas; Strieth, Sebastian; Wrede, Holger; Schlenter, Wolfgang W; Welkoborsky, Hans-Jürgen; Wollenberg, Barbara; Becker, Sven; Bärhold, Fredericke; Klimek, Felix; Casper, Ingrid; Zuberbier, Jaron; Rudack, Claudia; Cuevas, Mandy; Hintschich, Constantin A; Guntinas-Lichius, Orlando; Stöver, Timo; Bergmann, Christoph; Werminghaus, Pascal; Pfaar, Oliver; Gosepath, Jan; Gröger, Moritz; Beutner, Caroline; Laudien, Martin; Weber, Rainer K; Hildebrand, Tanja; Hoffmann, Anna S; Bachert, Claus.
Afiliación
  • Klimek L; Center for Rhinology and Allergology, Wiesbaden.
  • Förster-Ruhrmann U; HNO-University Clinic Charité, Berlin.
  • Olze H; HNO-University Clinic Charité, Berlin.
  • Beule AG; Clinic for Otorhinolaryngology, Münster University Hospital.
  • Chaker AM; Clinic for Otorhinolaryngology, Head and Neck Surgery at Greifswald University Medical Center.
  • Hagemann J; Department of Otolaryngology - Head and Neck Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich.
  • Huppertz T; Center of Allergy and Environment (ZAUM) of the Technical University of Munich.
  • Hoffmann TK; Clinic and Polyclinic for Otolaryngology, University Medical Center Mainz, Mainz.
  • Dazert S; Clinic and Polyclinic for Otolaryngology, University Medical Center Mainz, Mainz.
  • Deitmer T; Department of Otorhinolaryngology, Head and Neck Surgery, University of Ulm, Ulm.
  • Strieth S; Clinic for Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth Hospital.
  • Wrede H; German Society for Otorhinolaryngology, Head and Neck Surgery, Bonn.
  • Schlenter WW; Clinic and Polyclinic for Otorhinolaryngology, University Hospital Bonn.
  • Welkoborsky HJ; Ear, nose and throat specialist, Herford.
  • Wollenberg B; Medical Association of German Allergists, Wiesbaden.
  • Becker S; Clinic for Ear, Nose and Throat Medicine, Head and Neck Surgery, Nordstadt Clinic of the KRH, Hannover.
  • Bärhold F; Department of Otolaryngology - Head and Neck Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich.
  • Klimek F; HNO-University Clinic Tübingen.
  • Casper I; HNO-University Clinic Tübingen.
  • Zuberbier J; Center for Rhinology and Allergology, Wiesbaden.
  • Rudack C; Center for Rhinology and Allergology, Wiesbaden.
  • Cuevas M; HNO-University Clinic Charité, Berlin.
  • Hintschich CA; Clinic for Otorhinolaryngology, Münster University Hospital.
  • Guntinas-Lichius O; Clinic and Polyclinic for Otolaryngology, University Hospital Carl Gustav Carus, TU Dresden, Dresden.
  • Stöver T; Clinic and Polyclinic for Ear, Nose and Throat Medicine, University Hospital Regensburg, Regensburg.
  • Bergmann C; Clinic for Otorhinolaryngology, Jena University Hospital.
  • Werminghaus P; Otorhinolaryngology University Clinic Frankfurt am Main.
  • Pfaar O; HNO RKM740 Interdisciplinary Specialist Clinic, Düsseldorf, Germany.
  • Gosepath J; Praxis für Hals-, Nasen-, Ohrenheilkunde und Allergologie, Düsseldorf.
  • Gröger M; Clinic for Ear, Nose and Throat Medicine, University Hospital Giessen and Marburg GmbH, Marburg site, Philipps University Marburg, Marburg.
  • Beutner C; Clinic for Otorhinolaryngology, HSK Wiesbaden.
  • Laudien M; Clinic and Polyclinic for Otorhinolaryngology, University Hospital LMU Munich.
  • Weber RK; Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Germany Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen.
  • Hildebrand T; Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel.
  • Hoffmann AS; Clinic for Otorhinolaryngology, Karlsruhe Municipal Hospital.
  • Bachert C; Department of Ear, Nose and Throat Medicine, Freiburg University Medical Center.
Allergol Select ; 8: 26-39, 2024.
Article en En | MEDLINE | ID: mdl-38549814
ABSTRACT

BACKGROUND:

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial inflammatory disease of the mucous membranes of the nose and sinuses. Eosinophilic inflammation is described as a common endotype. The anti-IL-5 antibody mepolizumab was approved in November 2021 as an add-on therapy to intranasal glucocorticosteroids for the treatment of adults with severe chronic rhinosinusitis with nasal polyps when systemic glucocorticosteroids or surgery do not provide adequate disease control. While national and international recommendations exist for the use of mepolizumab in CRSwNP, it has not yet been adequately specified how this therapy should be monitored, what follow-up documentation is necessary, and when it should be discontinued if necessary. MATERIALS AND

METHODS:

A literature search was performed to analyze previous data on the treatment of CRSwNP with mepolizumab and to determine the available evidence by searching Medline, Pubmed, the national and international trial and guideline registries, and the Cochrane Library. Human studies published in the period up to and including 10/2022 were considered.

RESULTS:

Based on the international literature and previous experience by an expert panel, recommendations for follow-up, adherence to therapy intervals, and possible therapy breaks as well as discontinuation of therapy when using mepolizumab for the indication CRSwNP in the German healthcare system are given on the basis of a documentation sheet.

CONCLUSION:

Understanding the immunological basis of CRSwNP opens up new non-surgical therapeutic approaches with biologics for patients with severe, uncontrolled courses. Here, we provide recommendations for follow-up, adherence to therapy intervals, possible therapy pauses, or discontinuation of therapy when mepolizumab is used as add-on therapy with intranasal glucocorticosteroids to treat adult patients with severe CRSwNP that cannot be adequately controlled with systemic glucocorticosteroids and/or surgical intervention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Allergol Select Año: 2024 Tipo del documento: Article Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Allergol Select Año: 2024 Tipo del documento: Article Pais de publicación: Alemania