Indicating biologics for chronic rhinosinusitis with nasal polyps (CRSwNP): Recommendations by German allergy and ORL societies AeDA and DGHNO for dupilumab, omalizumab, and mepolizumab

Ludger Klimek, Ulrike Förster-Ruhrmann, Achim G. Beule, Adam M. Chaker, Jan Hagemann, Felix Klimek, Ingrid Casper, Tilman Huppertz, Thomas K. Hoffmann, Stefan Dazert, Thomas Deitmer, Heidi Olze, Sebastian Strieth, Holger Wrede, Wolfgang Schlenter, Hans Jürgen Welkoborsky, Barbara Wollenberg, Christoph Bergmann, Mandy Cuevas, Caroline BeutnerMoritz Gröger, Sven Becker

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP), an inflammatory disease of the paranasal mucosa, is primarily characterized by type 2 inflammation. Three antibodies (dupilumab, omalizumab, and mepolizumab) are now approved for the treatment of severe CRSwNP. Documentation of disease severity during the course of treatment is essential. Methods: A literature search of Medline, PubMed, and the national and international trial and guideline register, and the Cochrane Library was performed to analyze the immunology of CRSwNP and determine the evidence for the effect of dupilumab, omalizumab, and mepolizumab in this disease. This has resulted in 3 position papers prepared by our group of authors, which form the basis of this summarizing review. Results: Based on the information from the international literature, recommendations for the use of dupilumab, omalizumab, and mepolizumab in CRSwNP in the German health care system are given by an expert panel. Conclusion: Dupilumab, omalizumab, and mepolizumab are approved for patients 18 years of age and older with CRSwNP as add-on therapy to intranasal corticosteroids when, for dupilumab and mepolizumab, therapy with systemic corticosteroids and/or surgery does not achieve sufficient disease control. Therapy with omalizumab is indicated when therapy with intranasal corticosteroids does not result in sufficient disease control. Dedicated recommendations for the documentation of the use in the German health care system are given, which are based on the position papers of our author group already published on this topic.

Original languageEnglish
Pages (from-to)149-160
Number of pages12
JournalAllergo Journal International
Volume31
Issue number6
DOIs
StatePublished - Sep 2022
Externally publishedYes

Keywords

  • Dupilumab
  • Endotype classification
  • Mepolizumab
  • Mucosal immunology
  • Omalizumab
  • Treatment documentation

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