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Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps : a systematic review for the EAACI guidelines

Ioana Agache, Yang Song, Pablo Alonso-Coello, Yasmin Vogel, Claudio Rocha, Ivan Sola, Marilina Santero, Cezmi Akdis, Mubeccel Akdis, Giorgio Walter Canonica, et al.
(2021) ALLERGY. 76(8). p.2337-2353
Author
Organization
Abstract
This systematic review evaluates the efficacy and safety of biologicals for chronic rhinosinusitis with nasal polyps (CRSwNP) compared with the standard of care. PubMed, Embase, and Cochrane Library were searched for RCTs. Critical and important CRSwNP-related outcomes were considered. The risk of bias and the certainty of the evidence were assessed using GRADE. RCTs evaluated (dupilumab-2, omalizumab-4, mepolizumab-2, and reslizumab-1) included 1236 adults, with follow-up of 20-64 weeks. Dupilumab reduces the need for surgery (NFS) or oral corticosteroid (OCS) use (RR 0.28; 95% CI 0.20-0.39, moderate certainty) and improves with high certainty smell evaluated with UPSIT score (mean difference (MD) +10.54; 95% CI +9.24 to +11.84) and quality of life (QoL) evaluated with SNOT-22 (MD -19.14; 95% CI -22.80 to -15.47), with fewer treatment-related adverse events (TAEs) (RR 0.95; 95% CI 0.89-1.02, moderate certainty). Omalizumab reduces NFS (RR 0.85; 95% CI 0.78-0.92, high certainty), decreases OCS use (RR 0.38; 95% CI 0.10-1.38, moderate certainty), and improves high certainty smell (MD +3.84; 95% CI +3.64 to +4.04) and QoL (MD -15.65; 95% CI -16.16 to -15.13), with increased TAE (RR 1.73; 95% CI 0.60-5.03, moderate certainty). There is low certainty for mepolizumab reducing NFS (RR 0.78; 95% CI 0.64-0.94) and improving QoL (MD -13.3; 95% CI -23.93 to -2.67) and smell (MD +0.7; 95% CI -0.48 to +1.88), with increased TAEs (RR 1.64; 95% CI 0.41-6.50). The evidence for reslizumab is very uncertain.
Keywords
chronic rhinosinusitis, dupilumab, mepolizumab, omalizumab, reslizumab

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MLA
Agache, Ioana, et al. “Efficacy and Safety of Treatment with Biologicals for Severe Chronic Rhinosinusitis with Nasal Polyps : A Systematic Review for the EAACI Guidelines.” ALLERGY, vol. 76, no. 8, 2021, pp. 2337–53, doi:10.1111/all.14809.
APA
Agache, I., Song, Y., Alonso-Coello, P., Vogel, Y., Rocha, C., Sola, I., … Jutel, M. (2021). Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps : a systematic review for the EAACI guidelines. ALLERGY, 76(8), 2337–2353. https://doi.org/10.1111/all.14809
Chicago author-date
Agache, Ioana, Yang Song, Pablo Alonso-Coello, Yasmin Vogel, Claudio Rocha, Ivan Sola, Marilina Santero, et al. 2021. “Efficacy and Safety of Treatment with Biologicals for Severe Chronic Rhinosinusitis with Nasal Polyps : A Systematic Review for the EAACI Guidelines.” ALLERGY 76 (8): 2337–53. https://doi.org/10.1111/all.14809.
Chicago author-date (all authors)
Agache, Ioana, Yang Song, Pablo Alonso-Coello, Yasmin Vogel, Claudio Rocha, Ivan Sola, Marilina Santero, Cezmi Akdis, Mubeccel Akdis, Giorgio Walter Canonica, Tomas Chivato, Stefano del Giacco, Thomas Eiwegger, Wytske Fokkens, Christos Georgalas, Philippe Gevaert, Claire Hopkins, Ludger Klimek, Valerie Lund, Robert Naclerio, Liam O’Mahony, Susanna Palkonen, Oliver Pfaar, Jurgen Schwarze, Michael B. Soyka, De Yun Wang, Luo Zhang, Carlos Canelo-Aybar, Oscar Palomares, and Marek Jutel. 2021. “Efficacy and Safety of Treatment with Biologicals for Severe Chronic Rhinosinusitis with Nasal Polyps : A Systematic Review for the EAACI Guidelines.” ALLERGY 76 (8): 2337–2353. doi:10.1111/all.14809.
Vancouver
1.
Agache I, Song Y, Alonso-Coello P, Vogel Y, Rocha C, Sola I, et al. Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps : a systematic review for the EAACI guidelines. ALLERGY. 2021;76(8):2337–53.
IEEE
[1]
I. Agache et al., “Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps : a systematic review for the EAACI guidelines,” ALLERGY, vol. 76, no. 8, pp. 2337–2353, 2021.
@article{8706316,
  abstract     = {{This systematic review evaluates the efficacy and safety of biologicals for chronic rhinosinusitis with nasal polyps (CRSwNP) compared with the standard of care. PubMed, Embase, and Cochrane Library were searched for RCTs. Critical and important CRSwNP-related outcomes were considered. The risk of bias and the certainty of the evidence were assessed using GRADE. RCTs evaluated (dupilumab-2, omalizumab-4, mepolizumab-2, and reslizumab-1) included 1236 adults, with follow-up of 20-64 weeks. Dupilumab reduces the need for surgery (NFS) or oral corticosteroid (OCS) use (RR 0.28; 95% CI 0.20-0.39, moderate certainty) and improves with high certainty smell evaluated with UPSIT score (mean difference (MD) +10.54; 95% CI +9.24 to +11.84) and quality of life (QoL) evaluated with SNOT-22 (MD -19.14; 95% CI -22.80 to -15.47), with fewer treatment-related adverse events (TAEs) (RR 0.95; 95% CI 0.89-1.02, moderate certainty). Omalizumab reduces NFS (RR 0.85; 95% CI 0.78-0.92, high certainty), decreases OCS use (RR 0.38; 95% CI 0.10-1.38, moderate certainty), and improves high certainty smell (MD +3.84; 95% CI +3.64 to +4.04) and QoL (MD -15.65; 95% CI -16.16 to -15.13), with increased TAE (RR 1.73; 95% CI 0.60-5.03, moderate certainty). There is low certainty for mepolizumab reducing NFS (RR 0.78; 95% CI 0.64-0.94) and improving QoL (MD -13.3; 95% CI -23.93 to -2.67) and smell (MD +0.7; 95% CI -0.48 to +1.88), with increased TAEs (RR 1.64; 95% CI 0.41-6.50). The evidence for reslizumab is very uncertain.}},
  author       = {{Agache, Ioana and Song, Yang and Alonso-Coello, Pablo and Vogel, Yasmin and Rocha, Claudio and Sola, Ivan and Santero, Marilina and Akdis, Cezmi and Akdis, Mubeccel and Canonica, Giorgio Walter and Chivato, Tomas and del Giacco, Stefano and Eiwegger, Thomas and Fokkens, Wytske and Georgalas, Christos and Gevaert, Philippe and Hopkins, Claire and Klimek, Ludger and Lund, Valerie and Naclerio, Robert and O'Mahony, Liam and Palkonen, Susanna and Pfaar, Oliver and Schwarze, Jurgen and Soyka, Michael B. and Wang, De Yun and Zhang, Luo and Canelo-Aybar, Carlos and Palomares, Oscar and Jutel, Marek}},
  issn         = {{0105-4538}},
  journal      = {{ALLERGY}},
  keywords     = {{chronic rhinosinusitis,dupilumab,mepolizumab,omalizumab,reslizumab}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{2337--2353}},
  title        = {{Efficacy and safety of treatment with biologicals for severe chronic rhinosinusitis with nasal polyps : a systematic review for the EAACI guidelines}},
  url          = {{http://doi.org/10.1111/all.14809}},
  volume       = {{76}},
  year         = {{2021}},
}
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