Journal of Asthma and Allergy (Jan 2022)

Expert Opinion on Biological Treatment of Chronic Rhinosinusitis with Nasal Polyps in the Gulf Region

  • Al-Ahmad M,
  • Alsaleh S,
  • Al-Reefy H,
  • Al Abduwani J,
  • Nasr I,
  • Al Abri R,
  • Alamadi AMH,
  • Fraihat AA,
  • Alterki A,
  • Abuzakouk M,
  • Marglani O,
  • Rand HA

Journal volume & issue
Vol. Volume 15
pp. 1 – 12

Abstract

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Mona Al-Ahmad,1 Saad Alsaleh,2 Heba Al-Reefy,3 Janan Al Abduwani,4 Iman Nasr,5 Rashid Al Abri,6 Ahmed Mohd Haider Alamadi,7 Ayman Ali Fraihat,8 Abdulmohsen Alterki,9 Mohamed Abuzakouk,10 Osama Marglani,11 Hussain Al Rand12 1Al-Rashed Allergy Centre, Kuwait, State of Kuwait; 2Rhinology and Endoscopic Skull Base Surgery Division, Otolaryngology – Head and Neck Surgery Department, King Saud University, Riyadh, Saudi Arabia; 3Awali Hospital, Manama, Bahrain; 4Al Nahda Hospital, MoH, Muscat, Oman; 5Royal Hospital, MoH, Muscat, Oman; 6Sultan Qaboos, University Hospital, Muscat, Oman; 7Al Kuwait Hospital, MoH, Dubai, United Arab Emirates; 8Sulaiman Al Habib Hospital, Dubai, United Arab Emirates; 9Department Otolaryngology, Head and Neck Surgery, Zain and Al Sabah Hospitals, Medical Department, Dasman Diabetes Institute, Kuwait, State of Kuwait; 10Cleveland Clinic, Abu Dhabi, United Arab Emirates; 11Umm Al Qura University, Makkah and KFSH&RC, Jeddah, Saudi Arabia; 12Dubai HealthCare City, Dubai, United Arab EmiratesCorrespondence: Hussain Al Rand Ministry of Health, P. O. Box 1853, Dubai, United Arab EmiratesTel +971 50-6464643Email [email protected]: Chronic rhinosinusitis (CRS) is defined as the inflammation of nose and paranasal sinuses, affecting the patients’ quality of life and productivity. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a principal clinical entity confirmed by the existence of chronic sinonasal inflammation and is characterized by anterior or posterior rhinorrhea, nasal congestion, hyposmia and/or facial pressure or facial pain. Several epidemiologic studies have revealed wide variations in the incidence of CRS among regions globally ranging from 4.6% to 12%. The Gulf countries are also witnessing an unprecedented burden of CRSwNP. According to the current clinical guidelines, glucocorticosteroids and antibiotics are the principal pharmacotherapeutic approaches. Endoscopic sinus surgery is recommended for those who have failed maximal pharmacotherapy. Recently, biologics are considered as an alternative best approach due to the complications associated with medical therapy and surgery. However, precise data on the clinical position of biologic agents in the management of CRSwNP in the Gulf region is not available. The present review article addresses the current diagnostic and management approaches for CRSwNP and also emphasizes the role of emerging biologics in the current treatment strategies for CRSwNP in the Gulf region. Further, a consensus protocol was convened to rationalize the guideline recommendations, strategize the best practices with biologics, and develop clinical practice guidelines for all primary-care specialists in the Gulf region. The consensus-based report will be a useful reference tool for primary-care physicians in primary-healthcare settings, regarding the appropriate time for the initiation of biological treatment in the Gulf region.Keywords: paranasal sinuses, glucocorticosteroids, endoscopic sinus surgery, inflammation, rhinorrhea

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