Monitoring mepolizumab treatment in chronic rhinosinusitis with nasal polyps (CRSwNP): Discontinue, change, continue therapy?

被引：1

作者：

Klimek, L. ^{[1
]}

Foerster-Ruhrmann, U. ^{[2
]}

Olze, H. ^{[2
]}

Beule, A. G. ^{[3
,4
]}

Chaker, A. ^{[5
,6
]}

Hagemann, J. ^{[7
]}

Huppertz, T. ^{[7
]}

Hoffmann, T. K. ^{[8
]}

Dazert, S. ^{[9
]}

Deitmer, T. ^{[10
]}

Strieth, S. ^{[11
]}

Wrede, H. ^{[12
]}

Schlenter, W. ^{[13
]}

Welkoborsky, H. J. ^{[14
]}

Wollenberg, B. ^{[5
]}

Becker, S. ^{[15
]}

Baerhold, F. ^{[15
]}

Klimek, F. ^{[1
]}

Casper, I. ^{[1
]}

Zuberbier, J. ^{[2
]}

Rudack, C. ^{[3
]}

Cuevas, M. ^{[16
]}

Hintschich, C. A. ^{[17
]}

Guntinas-Lichius, O. ^{[18
]}

Stoever, T. ^{[19
]}

Bergmann, C. ^{[20
]}

Werminghaus, P. ^{[21
]}

Pfaar, O. ^{[21
,22
]}

Gosepath, J. ^{[23
]}

Groeger, M. ^{[24
]}

Beutner, C. ^{[25
]}

Laudien, M. ^{[26
]}

Weber, R. K. ^{[27
]}

Hildenbrand, T. ^{[28
]}

Hoffmann, A. S. ^{[29
]}

Bachert, C. ^{[30
]}

机构：

[1] Zentrum Rhinol & Allergol, Quellen 10, D-65183 Wiesbaden, Germany

[2] Charite Univ Med Berlin, Klin Hals Nasen & Ohrenheilkunde, Berlin, Germany

[3] Univ Klinikum Munster, Klin Hals Nasen & Ohrenheilkunde, Munster, Germany

[4] Univ Med Greifswald, Klin Hals Nasen Ohrenheilkunde Kopf & Halschirurg, Greifswald, Germany

[5] Tech Univ Munich, TUM Sch Med, Klin Hals Nasen & Ohrenheilkunde, Klinikum Rechts Isar, Munich, Germany

[6] Tech Univ Munich, Zentrum Allergie & Umwelt ZAUM, TUM Sch Med, Klinikum Rechts Isar, Munich, Germany

[7] Univ Med Mainz, Klin Hals Nasen & Ohrenheilkunde, Mainz, Germany

[8] Univ Klinikum Ulm, Klin Hals Nasen & Ohrenheilkunde, Ulm, Germany

[9] Ruhr Univ Bochum, Klin Hals Nasen Ohrenheilkunde Kopf & Halschirurg, St Elisabeth Hosp, Bochum, Germany

[10] Deutsch Gesell Hals Nasen & Ohrenheilkunde, Kopf & Halschirurg, Bonn, Germany

[11] Univ Klinikum Bonn, Klin & Poliklin Hals Nasen Ohren Heilkunde, Bonn, Germany

[12] Hals Nasen & Ohrenarzt, Herford, Germany

[13] Arzteverband Deutsch Allergologen, Wiesbaden, Germany

[14] Klinikum Hannover, Klin Hals Nasen & Ohrenheilkunde, Hannover, Germany

[15] Univ Klin Tubingen, Klin Hals Nasen & Ohrenheilkunde, Tubingen, Germany

[16] Tech Univ Dresden, Klin & Poliklin HNO Heilkunde, Univ Klinikum Carl Gustav Carus, Dresden, Germany

[17] Univ Klinikum Regensburg, Klin & Poliklin Hals Nasen Ohren Heilkunde, Regensburg, Germany

[18] Univ Klinikum Jena, Klin Hals Nasen & Ohren heilkunde, Jena, Germany

[19] Univ Hals Nasen Ohrenklin, Frankfurt, Germany

[20] Klin RKM 740, Praxis Hals Nasen Ohrenheilkunde, Dusseldorf, Germany

[21] Univ Klinikum Giessen & Marburg GmbH, Klin Hals Nasen & Ohrenheilkunde, Standort Marburg, Germany

[22] Philipps Univ Marburg, Marburg, Germany

[23] HSK Wiesbaden, Klin Hals Nasen & Ohrenheilkunde, Wiesbaden, Germany

[24] Univ Klinikum LMU Munchen, Klin & Poliklin Hals Nasen Ohrenheilkunde, Munich, Germany

[25] Univ Med Gottingen, Klin Dermatol Venerol & Allergol, Allergiezentrum Sudniedersachsen, Gottingen, Germany

[26] Univ Klinikum Kiel, Klin Hals Nasen & Ohrenheilkunde, Kiel, Germany

[27] Stadt Klinikum Karlsruhe, Klin Hals Nasen & Ohrenheilkunde, Karlsruhe, Germany

[28] Univ Klinikum Freiburg, Klin Hals Nasen & Ohrenheilkunde, Freiburg, Germany

[29] Univ Klinikum Hamburg Eppendorf, Klin Hals Nasen & Ohrenheilkunde, Hamburg, Germany

[30] Univ Klinikum Gent, Klin Hals Nasen & Ohrenheilkunde, Ghent, Belgium

来源：

ALLERGOLOGIE | 2024年 / 47卷 / 03期

关键词：

chronic rhinosinusitis-; CRSwNP; biologicals; eosinophilic inflammation; mepolizumab; ENDOSCOPIC SINUS SURGERY; ODOR IDENTIFICATION; GERMAN SOCIETY; POSITION PAPER; NORMATIVE DATA; ASTHMA; PREVALENCE; PLACEBO; DISCRIMINATION; RECURRENCE;

D O I：

10.5414/ALX02460E

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

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-IL5 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 is to be monitored, what follow-up documentation is necessary, and when it should be terminated if necessary. 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 termination of therapy when using mepolizumab for the indication CRSwNP in the German health care system are given on the basis of a documentation sheet. Conclusions: 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.

引用

页数：16

共 50 条

[21] Treatment options for chronic rhinosinusitis with nasal polyps
V. Wallace, Dana
ALLERGY AND ASTHMA PROCEEDINGS, 2021, 42 (06) : 450 - 460
[22] Anti-IgE therapy in chronic rhinosinusitis with nasal polyps
Chhiba, Krishan D.
Patel, Gayatri B.
Peters, Anju T.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2025, 155 (01) : 24 - 30
[23] Olfactory Dysfunction in Chronic Rhinosinusitis with Nasal Polyps: Effect of Treatment with Emphasis on Biological Therapy
Otten, Josje Janna
Fokkens, Wytske Johanna
Reitsma, Sietze
CURRENT ALLERGY AND ASTHMA REPORTS, 2025, 25 (01)
[24] Necroptosis Underlies Neutrophilic Inflammation Associated with the Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)
Xie, Yadong
Li, Min
Chen, Kun
Zhu, Haoxiang
Tang, Mengyao
Zhou, Chun
Zheng, Yaoming
Wen, Jing
Han, Miaomiao
Zhang, Jia
Zhao, Keqing
Xiao, Hui
Li, Huabin
JOURNAL OF INFLAMMATION RESEARCH, 2021, 14 : 3969 - 3983
[25] Mepolizumab in chronic rhinosinusitis with nasal polyposis
Liu, Xuandao
Charn, Tze Choong
Wang, De-Yun
IMMUNOTHERAPY, 2023, 15 (14) : 1105 - 1116
[26] Biomarkers in Chronic Rhinosinusitis with Nasal Polyps
Workman, Alan D.
Kohanski, Michael A.
Cohen, Noam A.
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 2018, 38 (04) : 679 - +
[27] Biologics for the treatment of chronic rhinosinusitis with nasal polyps - State of the Art
Zhang, N.
Bachert, C.
ALLERGOLOGIE, 2019, 42 (06) : 281 - 290
[28] Indirect Treatment Comparison of Biologics in Chronic Rhinosinusitis with Nasal Polyps
Peters, Anju T.
Han, Joseph K.
Hellings, Peter
Heffler, Enrico
Gevaert, Philippe
Bachert, Claus
Xu, Yingxin
Chuang, Chien-Chia
Neupane, Binod
Msihid, Jerome
Mannent, Leda P.
Guyot, Patricia
Kamat, Siddhesh
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2021, 9 (06) : 2461 - +
[29] Indicating biologics for chronic rhinosinusitis with nasal polyps (CRSwNP): Recommendations by German allergy and ORL societies AeDA and DGHNO for dupilumab, omalizumab, and mepolizumab
Klimek L.
Förster-Ruhrmann U.
Beule A.G.
Chaker A.M.
Hagemann J.
Klimek F.
Casper I.
Huppertz T.
Hoffmann T.K.
Dazert S.
Deitmer T.
Olze H.
Strieth S.
Wrede H.
Schlenter W.
Welkoborsky H.-J.
Wollenberg B.
Bergmann C.
Cuevas M.
Beutner C.
Gröger M.
Becker S.
Allergo Journal International, 2022, 31 (6) : 149 - 160
[30] Chronic Rhinosinusitis with Nasal Polyps
Stevens, Whitney W.
Schleimer, Robert P.
Kern, Robert C.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 2016, 4 (04) : 565 - +

← 1 2 3 4 5 →