EUFOREA consensus on biologics for CRSwNP with or without asthma

Wytske J Fokkens, Valerie Lund, Claus Bachert, Joaquim Mullol, Leif Bjermer, Jean Bousquet, Giorgio W Canonica, Lauren Deneyer, Martin Desrosiers, Zuzana Diamant, Joseph Han, Enrico Heffler, Claire Hopkins, Roger Jankowski, Guy Joos, Andrew Knill, Jivianne Lee, Stella E Lee, Gert Mariën, Benoit Pugin, Brent Senior, Sven F Seys, Peter W Hellings, Wytske J Fokkens, Valerie Lund, Claus Bachert, Joaquim Mullol, Leif Bjermer, Jean Bousquet, Giorgio W Canonica, Lauren Deneyer, Martin Desrosiers, Zuzana Diamant, Joseph Han, Enrico Heffler, Claire Hopkins, Roger Jankowski, Guy Joos, Andrew Knill, Jivianne Lee, Stella E Lee, Gert Mariën, Benoit Pugin, Brent Senior, Sven F Seys, Peter W Hellings

Abstract

Novel therapies such as type 2 targeting biologics are emerging treatment options for patients with chronic inflammatory respiratory diseases, fulfilling the needs of severely uncontrolled patients. The majority of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and over half of patients with asthma show a type 2 inflammatory signature in sinonasal mucosa and/or lungs. Importantly, both chronic respiratory diseases are frequent comorbidities, ensuring alleviation of both upper and lower airway pathology by systemic biological therapy. Type 2-targeting biologics such as anti-IgE, anti-IL4Rα, anti-IL5, and anti-IL5Rα have entered the market for selected pheno/endotypes of asthma patients and may soon also become available for CRSwNP patients. Given the high prevalence of chronic respiratory diseases and the high cost associated with biologics, patient selection is crucial in order to implement such therapies into chronic respiratory disease care pathways. The European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) organized a multidisciplinary Expert Board Meeting to discuss the positioning of biologics into the care pathways for CRSwNP patients with and without comorbid asthma.

Keywords: asthma; biologics; chronic rhinosinusitis; nasal polyps; type 2 inflammation.

Conflict of interest statement

Dr. Diamant reports personal fees from AstraZeneca, personal fees from Sanofi‐Genzyme, during the conduct of the study; personal fees from Aquilon, personal fees from ALK, personal fees from Boehringer Ingelheim, personal fees from Gilead, personal fees from Hal Allergy, personal fees from MSD, outside the submitted work; and Apart from my academic affiliations I work at a phase I/II unit performing clinical studies for different biotech and pharma companies. Dr. Bachert reports personal fees from Sanofi, personal fees from GSK, personal fees from Novartis, personal fees from Astra‐Zeneca, during the conduct of the study. Dr. Bousquet reports personal fees from Chiesi, Cipla, Hikma, Menarini, Mundipharma, Mylan, Novartis, Sanofi‐Aventis, Takeda, Teva, Uriach, other from KYomed‐Innov, outside the submitted work. Dr Han reports to be consultant for Sanofi/Genzyme Regeneron and Astra‐Zeneca. Dr. Hellings reports grants and personal fees from Mylan, during the conduct of the study; personal fees from Sanofi, personal fees from Allergopharma, personal fees from Stallergenes, outside the submitted work. Dr. Hopkins reports personal fees from Advisory Board Participation ‐ Sanofi, personal fees from Advisory Board Participation – Glaxo Smith Kline, personal fees from Advisory Board Participation ‐ Optinose, personal fees from Advisory Board Participation – Smith and Nephew, outside the submitted work. Dr. J. Lee reports grants from Astra‐Zeneca, personal fees from Regeneron Healthcare Solutions, during the conduct of the study. Dr. Jankowski reports personal fees from sanofi regeneron, outside the submitted work. Dr. Joos reports grants and personal fees from AstraZeneca, personal fees from Eureca vzw, grants from Chiesi, grants and personal fees from GlaxoSmithKline, personal fees from Teva, outside the submitted work; all payments were done to his employer. Dr. S. Lee reports grants from Sanofi Regeneron, grants from Allakos Inc, grants from Astra Zeneca, other from Novartis, other from Sanofi Regeneron, outside the submitted work. Dr. Lund reports non‐financial support from GSK, grants from GSK, during the conduct of the study; personal fees from Abbott, personal fees from Kyorin, personal fees from MIMS, personal fees from MSD, personal fees from Elsevier Editor, outside the submitted work. Dr. Mullol reports personal fees and other from SANOFI‐GENZYME & REGENERON, NOVARTIS, and ALLAKOS; grants and personal fees from MYLAN Pharma and URIACH Group; and personal fees from ALK‐Abelló A/S, Menarini, and UCB, outside the submitted work. Dr. Heffler reports grants from AstraZeneca, grants from GSK, grants from Sanofi‐Genzyme, grants from Novartis, grants from Nestlè Purina, grants from Circassia, outside the submitted work. Dr Fokkens reports grants from Sanofi, grants from GSK, grants from Novartis, during the conduct of the study. Dr. Bjermer, Dr. Deneyer, Dr. Desrosiers, Dr. Knill, Dr. Mariën, Dr. Seys, Dr. Senior, Dr. Pugin hava nothing to disclose.

© 2019 The Authors Allergy Published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Indications for biological treatment in patients with CRSwNP: proposal of the multidisciplinary EUFOREA Expert Board Meeting
Figure 2
Figure 2
Response criteria for biological treatment in patients with CRSwNP: proposal of the multidisciplinary EUFOREA Expert Board Meeting

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