Laryngorhinootologie 2020; 99(08): 511-527
DOI: 10.1055/a-1197-0136
Leitlinien und Empfehlungen

Positionspapier: Anwendung von Biologika bei chronischer Rhinosinusitis mit Polyposis nasi (CRSwNP) im deutschen Gesundheitssystem – Empfehlungen des Ärzteverbandes Deutscher Allergologen (AeDA) und der AGs Klinische Immunologie, Allergologie und Umweltmedizin und Rhinologie und Rhinochirurgie der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie (DGHNOKHC)

L. Klimek
1   Zentrum für Rhinologie und Allergologie, Wiesbaden
,
U. Förster-Ruhrmann
2   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Charité, Berlin
,
S. Becker
3   Hals-Nasen-Ohrenklinik und Poliklinik, Universitätsklinik Tübingen
,
A. Chaker
4   Klinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München
,
S. Strieth
5   Klinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn
,
T. K. Hoffmann
6   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Ulm
,
S. Dazert
7   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Bochum
,
T. Deitmer
8   Deutsche Gesellschaft für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Bonn
,
H. Olze
2   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Charité, Berlin
,
A. Glien
9   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Halle
,
S. Plontke
9   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Halle
,
H. Wrede
10   Hals-, Nasen- und Ohrenarzt, Herford
,
W. Schlenter
11   Ärzteverband Deutscher Allergologen, Dreieich
,
H. J. Welkoborsky
12   Klinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum Hannover
,
B. Wollenberg
4   Klinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München
,
A. G. Beule
13   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster
,
C. Rudack
13   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster
,
M. Wagenmann
14   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Düsseldorf
,
T. Stöver
15   Klinik für Hals, Nasen- und Ohrenheilkunde Universitätsklinikum Frankfurt am Main
,
T. Huppertz
16   Klinik fur Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Mainz
,
J. Hagemann
16   Klinik fur Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Mainz
,
C. Bachert
17   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Gent, Belgien
› Author Affiliations

Zusammenfassung

Hintergrund Die chronische Rhinosinusitis (CRS) betrifft weltweit ca. 5–12 % der Allgemeinbevölkerung und wird traditionell eingeteilt in einen Phänotyp ohne (CRSsNP) und einen mit Ausbildung von Nasenpolypen (CRSwNP). Wurden Nasenpolypen bis vor kurzem eher als mechanisches Hindernis mit der Notwendigkeit einer operativen Beseitigung betrachtet, wird die CRSwNP heute als eine multifaktorielle entzündliche Erkrankung der nasalen und paranasalen Schleimhäute angesehen, der als Endotyp häufig eine T2-Inflammation zugrunde liegt. Biologika, die mit diesen Entzündungsmechanismen interferieren, stellen interessante neue Therapiemöglichkeiten dar.

Methoden Das aktuelle Wissen zur Immunologie der CRSwNP und Wirkung von Biologika wurde mittels einer Literaturanalyse durch Recherchen in Medline, PubMed sowie den nationalen und internationalen Studien- und Leitlinienregistern und der Cochrane Library zusammengestellt.

Ergebnisse Basierend auf der internationalen Literatur und bisherigen Erfahrungen werden von einem Expertengremium Empfehlungen für die Anwendung von Biologika bei CRSwNP im deutschen Gesundheitssystem auf der Grundlage eines Dokumentationsbogens gegeben.

Schlussfolgerung Das Verständnis über die immunologischen Grundlagen der CRSwNP eröffnet neue nichtoperative Therapieansätze mit Biologika für Patienten mit schweren Verlaufsformen.



Publication History

Article published online:
23 June 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 
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