Download PDF
Laryngorhinootologie 2021; 100(12): 952-963
DOI: 10.1055/a-1644-4066
Leitlinien und Empfehlungen

Positionspapier: Empfehlungen zur Anwendung von Omalizumab 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   Charité – Universitätsmedizin Berlin
,
A. G. Beule
3   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster
,
A. M. Chaker
4   Klinik für Hals-, Nasen- und Ohrenheilkunde, TUM School of Medicine, Klinikum rechts der Isar, Technische Universität München
5   Zentrum für Allergie und Umwelt (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technische Universität München
,
J. Hagemann
6   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Mainz
,
T. Huppertz
6   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsmedizin Mainz
,
T. K. Hoffmann
7   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Ulm
,
S. Dazert
8   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum, St. Elisabeth-Hospital, Bochum
,
T. Deitmer
9   Deutsche Gesellschaft für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Bonn
,
H. Olze
2   Charité – Universitätsmedizin Berlin
,
S. Strieth
10   Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn (UKB)
,
H. Wrede
11   Hals-, Nasen- und Ohrenarzt, Herford
,
W. Schlenter
12   Ärzteverband Deutscher Allergologen, Dreieich
,
H. J. Welkoborsky
13   Klinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum Hannover
,
B. Wollenberg
4   Klinik für Hals-, Nasen- und Ohrenheilkunde, TUM School of Medicine, Klinikum rechts der Isar, Technische Universität München
,
S. Becker
14   Hals-, Nasen-, Ohrenklinik und Poliklinik, Universitätsklinik Tübingen
,
C. Rudack
3   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster
,
M. Wagenmann
15   Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Düsseldorf
,
C. Bergmann
16   Praxis für Hals-, Nasen-, Ohrenheilkunde, Klinik RKM 740, Düsseldorf
,
C. Bachert
17   Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Gent, Belgien
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund Die chronische Rhinosinusitis mit Nasenpolypen (CRSwNP) ist eine multifaktorielle entzündliche Erkrankung der paranasalen Schleimhäute, der als Endotyp meistens eine TH2-Inflammation zugrunde liegt. IgE-Antikörper spielen dabei eine wichtige Rolle. Der anti-IgE-Antikörper Omalizumab wurde im August 2020 für die Therapie der schweren CRSwNP zugelassen.

Methoden In einer Literatursuche wurde die Immunologie der CRSwNP analysiert und die Evidenz zur Wirkung von Omalizumab bei dieser Erkrankung ermittelt durch Recherchen in Medline, Pubmed sowie den nationalen und internationalen Studien- und Leitlinien-Registern und der Cochrane Library.

Ergebnisse Basierend auf diesen Angaben aus der internationalen Literatur werden von einem Expertengremium Empfehlungen für die Anwendung von Omalizumab bei CRSwNP im deutschen Gesundheitssystem gegeben.

Schlussfolgerung Omalizumab ist zugelassen für Patienten ab 18 Jahren mit schwerer chronischer Rhinosinusitis mit Nasenpolypen als Zusatztherapie zu intranasalen Kortikosteroiden (INCS), wenn durch eine Therapie mit INCS keine ausreichende Krankheitskontrolle erzielt werden kann.

Schlüsselwörter

chronische Rhinosinusitis - Endotyp-Klassifizierung - nasale Polypen - CRSwNP - Biologika - Omalizumab - COVID-19

Supplement



Publication History

Article published online:
30 September 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Ohnmacht C. Microbiota, regulatory T cell subsets, and allergic disorders. Allergo J Int 2016; 25: 114-123 DOI: 10.1007/s40629-016-0118-0.
    CrossrefPubMedGoogle Scholar
  • 2 Ono S, Kabashima K. Novel insights into the role of immune cells in skin and inducible skin-associated lymphoid tissue (iSALT). Allergo J Int 2015; 24: 170-179 DOI: 10.1007/s40629-015-0065-1.
    CrossrefPubMedGoogle Scholar
  • 3 Klimek L, Koennecke M, Hagemann J. et al [Immunology of chronic rhinosinusitis with nasal polyps as a basis for treatment with biologicals]. HNO 2019; 67: 15-26 DOI: 10.1007/s00106-018-0557-7.
    CrossrefPubMedGoogle Scholar
  • 4 Koennecke M, Klimek L, Mullol J. et al Subtyping of polyposis nasi: phenotypes, endotypes and comorbidities. Allergo journal international 2018; 27: 56-65 DOI: 10.1007/s40629-017-0048-5 doi.
    CrossrefPubMedGoogle Scholar
  • 5 Galli SJ, Metz M, Starkl P. et al Mast cells and IgE in defense against lethality of venoms: Possible “benefit” of allergy. Allergo J Int 2020; 29: 46-62 DOI: 10.1007/s40629-020-00118-6.
    CrossrefPubMedGoogle Scholar
  • 6 Kabesch M. Epigenetic determinants of allergy and tolerance. Allergo Journal 2016; 25: 32-37 DOI: 10.1007/s15007-016-1170-2.
    CrossrefPubMedGoogle Scholar
  • 7 Sutton BJ, Davies AM. Structure and dynamics of IgE-receptor interactions: FcepsilonRI and CD23/FcepsilonRII. Immunol Rev 2015; 268: 222-235 DOI: 10.1111/imr.12340.
    CrossrefPubMedGoogle Scholar
  • 8 Hastan D, Fokkens WJ, Bachert C. et al Chronic rhinosinusitis in Europe – an underestimated disease. A GA²LEN study. Allergy 2011; 66: 1216-1223 DOI: 10.1111/j.1398-9995.2011.02646.x. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 9 Hirsch AG, Stewart WF, Sundaresan AS. et al Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy 2017; 72: 274-281 DOI: 10.1111/all.13042.
    CrossrefPubMedGoogle Scholar
  • 10 Ostovar A, Fokkens WJ, Vahdat K. et al Epidemiology of chronic rhinosinusitis in Bushehr, southwestern region of Iran: a GA2LEN study. Rhinology 2019; 57: 43-48 DOI: 10.4193/Rhin18.061.
    CrossrefPubMedGoogle Scholar
  • 11 Shi JB, Fu QL, Zhang H. et al Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy 2015; 70: 533-539 DOI: 10.1111/all.12577.
    CrossrefPubMedGoogle Scholar
  • 12 Stuck BA, Beule A, Jobst D. et al [Guideline for “rhinosinusitis”-long version: S2k guideline of the German College of General Practitioners and Family Physicians and the German Society for Oto-Rhino-Laryngology, Head and Neck Surgery]. HNO 2018; 66: 38-74 DOI: 10.1007/s00106-017-0401-5.
    CrossrefPubMedGoogle Scholar
  • 13 Fokkens WJ, Lund VJ, Mullol J. et al European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 2012; 23: 3p preceding table of contents, 1-298
    Google Scholar
  • 14 Fokkens WJ, Lund VJ, Mullol J. et al EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012; 50: 1-12 DOI: 10.4193/Rhino50E2.
    Google Scholar
  • 15 Rosenfeld RM. Clinical practice guideline on adult sinusitis. Otolaryngology – head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery 2007; 137: 365-377 DOI: 10.1016/j.otohns.2007.07.021. . doi:46829 de-38m
    CrossrefPubMedGoogle Scholar
  • 16 Agarwal A, Spath D, Sherris DA. et al Therapeutic Antibodies for Nasal Polyposis Treatment: Where Are We Headed?. Clinical reviews in allergy & immunology 2019; 59: 141-149 DOI: 10.1007/s12016-019-08734-z. . doi:351562 de-38m
    CrossrefPubMedGoogle Scholar
  • 17 Franzese CB. The Role of Biologics in the Treatment of Nasal Polyps. Immunology and allergy clinics of North America 2020; 40: 295-302 DOI: 10.1016/j.iac.2019.12.006. . doi:133755 de-38m
    CrossrefPubMedGoogle Scholar
  • 18 Klimek L, Förster-Ruhrmann U, Becker S. et al 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). Laryngo-Rhino-Otol 2020; 99 (08) 511-527 DOI: 10.1055/a-1197-0136. . doi:204768 de-38m
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Jutel M, Van de Veen W, Agache I. et al Mechanisms of allergen-specific immunotherapy and novel ways for vaccine development. Allergology international: official journal of the Japanese Society of Allergology 2013; 62: 425-433 DOI: 10.2332/allergolint.13-RAI-0608. . doi:482779 de-38m
    CrossrefPubMedGoogle Scholar
  • 20 Klimek L, Bachert C, Pfaar O. et al ARIA guideline 2019: treatment of allergic rhinitis in the German health system. Allergologie select 2019; 3: 22-50 DOI: 10.5414/ALX02120E. . doi:1016429 de-38m
    CrossrefPubMedGoogle Scholar
  • 21 Klimek L, Brehler R, Hamelmann E. et al CME Zertifizierte Fortbildung. Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen. Allergo J Int 2019; 28: 107–119: Development of subcutaneous allergen immunotherapy (part 2): preventive aspects and innovations/CME-Fragebogen. Allergo-Journal 2019; 28: 31/45 . doi:317060 de-38m
    PubMedGoogle Scholar
  • 22 Klimek L, Brehler R, Hamelmann E. et al CME-Fortbildung. Entwicklung der subkutanen Allergen- Immuntherapie (Teil 1): von den Anfängen zu immunologisch orientierten Therapiekonzepten. Evolution of subcutaneous allergen immunotherapy (part 1): from first developments to mechanism-driven therapy concepts. Allergo J Int 2019;28:78-95 / CME-Fragebogen. Allergo-Journal 2019; 28: 26-47 . doi:317060 de-38m
    PubMedGoogle Scholar
  • 23 Klimek L, Casper I, Bergmann KC. Positionspapier. Die Therapie der allergischen Rhinitis in der Routineversorgung: evidenzbasierte Nutzenbewertung der kombinierten Anwendung mehrerer Wirkstoffe. Therapy of allergic rhinitis in routine care: evidence-based benefit assessment of freely combined use of various active ingredients. Allergologie 2020; 43: 476 . doi:50376de-38m
    CrossrefPubMedGoogle Scholar
  • 24 Ade R, Rehm M. A prediction of dust mite populations in different categories of housing quality in Auckland, New Zealand. Allergo Journal International 2020; 29: 187-198 DOI: 10.1007/s40629-020-00130-w.
    CrossrefPubMedGoogle Scholar
  • 25 Pitsios C, Pantavou K, Terreehorst I. et al Use of allergy tests to identify dietary and environmental triggers of eosinophilic esophagitis: protocol for a systematic review. Allergo Journal International 2020; 29: 280-283 DOI: 10.1007/s40629-020-00141-7.
    CrossrefPubMedGoogle Scholar
  • 26 Seidenberg J, Stelljes G, Lange L. et al Airlines provide too little information for allergy sufferers!. Allergo Journal International 2020; 29: 262-279 DOI: 10.1007/s40629-020-00147-1.
    CrossrefPubMedGoogle Scholar
  • 27 Johns CB, Laidlaw TM. Elevated total serum IgE in nonatopic patients with aspirin-exacerbated respiratory disease. Am J Rhinol Allergy 2014; 28: 287-289 DOI: 10.2500/ajra.2014.28.4054.
    CrossrefPubMedGoogle Scholar
  • 28 Annunziato F, Romagnani S. Heterogeneity of human effector CD4+ T cells. Arthritis research & therapy 2009; 11: 257 . doi:10.1186/ar2843. doi:599177de-38m
    CrossrefPubMedGoogle Scholar
  • 29 Plager DA, Kahl JC, Asmann YW. et al Gene transcription changes in asthmatic chronic rhinosinusitis with nasal polyps and comparison to those in atopic dermatitis. PloS one 2010; 5: e11450 . doi:10.1371/journal.pone.0011450
    CrossrefPubMedGoogle Scholar
  • 30 Van Zele T, Claeys S, Gevaert P. et al Differentiation of chronic sinus diseases by measurement of inflammatory mediators. Allergy 2006; 61: 1280-1289 DOI: 10.1111/j.1398-9995.2006.01225.x. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 31 Zygmunt B, Veldhoen M. T helper cell differentiation more than just cytokines. Advances in immunology 2011; 109: 159-196 DOI: 10.1016/B978-0-12-387664-5.00005-4. . doi:43811 de-38m
    CrossrefPubMedGoogle Scholar
  • 32 Kopf M, Le Gros G, Bachmann M. et al Disruption of the murine IL-4 gene blocks Th2 cytokine responses. Nature 1993; 362: 245-248 DOI: 10.1038/362245a0. . doi:43481 de-38m
    CrossrefPubMedGoogle Scholar
  • 33 Ouyang W, Ranganath SH, Weindel K. et al Inhibition of Th1 development mediated by GATA-3 through an IL-4-independent mechanism. Immunity 1998; 9: 745-755 . doi:351310 de-38m
    CrossrefPubMedGoogle Scholar
  • 34 Danielsen A, Tynning T, Brokstad KA. et al Interleukin 5, IL6, IL12, IFN-gamma, RANTES and Fractalkine in human nasal polyps, turbinate mucosa and serum. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology – Head and Neck Surgery 2006; 263: 282-289 DOI: 10.1007/s00405-005-1031-1. . doi:219928 de-38m
    CrossrefPubMedGoogle Scholar
  • 35 Derycke L, Eyerich S, Van Crombruggen K. et al Mixed T helper cell signatures in chronic rhinosinusitis with and without polyps. PloS one 2014; 9: e97581 . doi:10.1371/journal.pone.0097581
    CrossrefPubMedGoogle Scholar
  • 36 Li Z, Zhang Y, Sun B. Current understanding of Th2 cell differentiation and function. Protein & cell 2011; 2: 604-611 DOI: 10.1007/s13238-011-1083-5.
    CrossrefPubMedGoogle Scholar
  • 37 Prussin C, Yin Y, Upadhyaya B. T(H)2 heterogeneity: Does function follow form?. The Journal of allergy and clinical immunology 2010; 126: 1094-1098 DOI: 10.1016/j.jaci.2010.08.031. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 38 Eckl-Dorna J, Pree I, Reisinger J. et al The majority of allergen-specific IgE in the blood of allergic patients does not originate from blood-derived B cells or plasma cells. Clin Exp Allergy 2012; 42: 1347-1355 DOI: 10.1111/j.1365-2222.2012.04030.x.
    CrossrefPubMedGoogle Scholar
  • 39 Bachert C, Wagenmann M, Hauser U. et al IL-5 synthesis is upregulated in human nasal polyp tissue. The Journal of allergy and clinical immunology 1997; 99: 837-842 . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 40 Bachert C, Gevaert P, Holtappels G. et al Nasal polyposis: from cytokines to growth. American journal of rhinology 2000; 14: 279-290 . doi:348449 de-38m
    CrossrefPubMedGoogle Scholar
  • 41 Hurst SM, Wilkinson TS, McLoughlin RM. et al Il-6 and its soluble receptor orchestrate a temporal switch in the pattern of leukocyte recruitment seen during acute inflammation. Immunity 2001; 14: 705-714 . doi:351310 de-38m
    CrossrefPubMedGoogle Scholar
  • 42 Jones SA. Directing transition from innate to acquired immunity: defining a role for IL-6. Journal of immunology (Baltimore, Md: 1950) 2005; 175: 3463-3468 . doi:60148 de-38m
    CrossrefPubMedGoogle Scholar
  • 43 Kaplanski G, Marin V, Montero-Julian F. et al IL-6: a regulator of the transition from neutrophil to monocyte recruitment during inflammation. Trends in immunology 2003; 24: 25-29 . doi:485944 de-38m
    CrossrefPubMedGoogle Scholar
  • 44 Chin D, Harvey RJ. Nasal polyposis: an inflammatory condition requiring effective anti-inflammatory treatment. Current opinion in otolaryngology & head and neck surgery 2013; 21: 23-30 DOI: 10.1097/MOO.0b013e32835bc3f9. . doi:351458 de-38m
    CrossrefPubMedGoogle Scholar
  • 45 Kato A. Immunopathology of chronic rhinosinusitis. Allergology international: official journal of the Japanese Society of Allergology 2015; 64: 121-130 DOI: 10.1016/j.alit.2014.12.006. . doi:482779 de-38m
    CrossrefPubMedGoogle Scholar
  • 46 Lam EPS, Kariyawasam HH, Rana BMJ. et al IL-25/IL-33-responsive TH2 cells characterize nasal polyps with a default TH17 signature in nasal mucosa. The Journal of allergy and clinical immunology 2016; 137: 1514-1524 DOI: 10.1016/j.jaci.2015.10.019. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 47 Arend WP, Palmer G, Gabay C. IL-1, IL-18, and IL-33 families of cytokines. Immunological reviews 2008; 223: 20-38 . doi:29355 de-38m DOI: 10.1111/j.1600-065X.2008.00624.x.
    CrossrefPubMedGoogle Scholar
  • 48 Kim DK, Jin HR, Eun KM. et al The role of interleukin-33 in chronic rhinosinusitis. Thorax 2017; 72: 635-645 DOI: 10.1136/thoraxjnl-2016-208772. . doi:283139 de-38m
    CrossrefPubMedGoogle Scholar
  • 49 Reh DD, Wang Y, Ramanathan M. et al Treatment-recalcitrant chronic rhinosinusitis with polyps is associated with altered epithelial cell expression of interleukin-33. American journal of rhinology & allergy 2010; 24: 105-109 DOI: 10.2500/ajra.2010.24.3446. . doi:791174 de-38m
    CrossrefPubMedGoogle Scholar
  • 50 Bachert C, Zhang N, Hellings PW. et al Endotype-driven care pathways in patients with chronic rhinosinusitis. The Journal of allergy and clinical immunology 2018; 141: 1543-1551 DOI: 10.1016/j.jaci.2018.03.004. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 51 De Schryver E, Devuyst L, Derycke L. et al Local immunoglobulin e in the nasal mucosa: clinical implications. Allergy, asthma & immunology research 2015; 7: 321-331 DOI: 10.4168/aair.2015.7.4.321. . doi:822656 de-38m
    CrossrefPubMedGoogle Scholar
  • 52 Gevaert P, Nouri-Aria KT, Wu H. et al Local receptor revision and class switching to IgE in chronic rhinosinusitis with nasal polyps. Allergy 2013; 68: 55-63 DOI: 10.1111/all.12054. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 53 Cherry WB, Yoon J, Bartemes KR. et al A novel IL-1 family cytokine, IL-33, potently activates human eosinophils. The Journal of allergy and clinical immunology 2008; 121: 1484-1490 DOI: 10.1016/j.jaci.2008.04.005. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 54 Mjösberg JM, Trifari S, Crellin NK. et al Human IL-25- and IL-33-responsive type 2 innate lymphoid cells are defined by expression of CRTH2 and CD161. Nature immunology 2011; 12: 1055-1062 DOI: 10.1038/ni.2104. . doi:483981 de-38m
    CrossrefPubMedGoogle Scholar
  • 55 Robinette ML, Colonna M. Immune modules shared by innate lymphoid cells and T cells. The Journal of allergy and clinical immunology 2016; 138: 1243-1251 DOI: 10.1016/j.jaci.2016.09.006. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 56 Halderman AA, Lane AP. Immunomodulators in the Treatment of Nasal Polyposis. Advances in oto-rhino-laryngology 2016; 79: 103-113 DOI: 10.1159/000445141. . doi:29578 de-38m
    CrossrefPubMedGoogle Scholar
  • 57 Naclerio R, Baroody F, Bachert C. et al Clinical Research Needs for the Management of Chronic Rhinosinusitis with Nasal Polyps in the New Era of Biologics: A National Institute of Allergy and Infectious Diseases Workshop. The journal of allergy and clinical immunology In practice 2020; 8: 1532-1549.e1531 DOI: 10.1016/j.jaip.2020.02.023. . doi:917835 de-38m
    CrossrefPubMedGoogle Scholar
  • 58 Ho J, Bailey M, Zaunders J. et al Cellular comparison of sinus mucosa vs polyp tissue from a single sinus cavity in chronic rhinosinusitis. International forum of allergy & rhinology 2015; 5: 14-27 DOI: 10.1002/alr.21417. . doi:868989 de-38m
    CrossrefPubMedGoogle Scholar
  • 59 Ho J, Bailey M, Zaunders J. et al Group 2 innate lymphoid cells (ILC2s) are increased in chronic rhinosinusitis with nasal polyps or eosinophilia. Clinical and experimental allergy: journal of the British Society for Allergy and Clinical Immunology 2015; 45: 394-403 DOI: 10.1111/cea.12462. . doi:175877 de-38m
    CrossrefPubMedGoogle Scholar
  • 60 Liao B, Liu JX, Li ZY. et al Multidimensional endotypes of chronic rhinosinusitis and their association with treatment outcomes. Allergy 2018; 73: 1459-1469 DOI: 10.1111/all.13411. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 61 Philpott CM, Erskine S, Hopkins C. et al Prevalence of asthma, aspirin sensitivity and allergy in chronic rhinosinusitis: data from the UK National Chronic Rhinosinusitis Epidemiology Study. Respiratory research 2018; 19: 129 DOI: 10.1186/s12931-018-0823-y. . doi:986957 de-38m
    CrossrefPubMedGoogle Scholar
  • 62 Wu D, Bleier BS, Li L. et al Clinical Phenotypes of Nasal Polyps and Comorbid Asthma Based on Cluster Analysis of Disease History. J Allergy Clin Immunol Pract 2018; 6: 1297-1305 e1291 DOI: 10.1016/j.jaip.2017.09.020.
    CrossrefPubMedGoogle Scholar
  • 63 Khan A, Vandeplas G, Huynh TMT. et al The Global Allergy and Asthma European Network (GALEN rhinosinusitis cohort: a large European cross-sectional study of chronic rhinosinusitis patients with and without nasal polyps. Rhinology 2018; 57: 32-42 DOI: 10.4193/Rhin17.255. . doi:341423 de-38m
    Google Scholar
  • 64 Langdon C, Mullol J. Nasal polyps in patients with asthma: prevalence, impact, and management challenges. Journal of asthma and allergy 2016; 9: 45-53 DOI: 10.2147/JAA.S86251. . doi:797791 de-38m
    CrossrefPubMedGoogle Scholar
  • 65 Tomassen P, Vandeplas G, Van Zele T. et al Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers. The Journal of allergy and clinical immunology 2016; 137: 1449-1456.e1444 DOI: 10.1016/j.jaci.2015.12.1324. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 66 Lin DC, Chandra RK, Tan BK. et al Association between severity of asthma and degree of chronic rhinosinusitis. American journal of rhinology & allergy 2011; 25: 205-208 DOI: 10.2500/ajra.2011.25.3613. . doi:791174 de-38m
    CrossrefPubMedGoogle Scholar
  • 67 Shaw DE, Sousa AR, Fowler SJ. et al Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort. The European respiratory journal 2015; 46: 1308-1321 DOI: 10.1183/13993003.00779-2015. . doi:145674 de-38m
    CrossrefPubMedGoogle Scholar
  • 68 De Greve G, Hellings PW, Fokkens WJ. et al Endotype-driven treatment in chronic upper airway diseases. Clinical and translational allergy 2017; 7: 22 DOI: 10.1186/s13601-017-0157-8. . doi:871682 de-38m
    CrossrefPubMedGoogle Scholar
  • 69 Seys SF, Scheers H, Van den Brande P. et al Cluster analysis of sputum cytokine-high profiles reveals diversity in T(h)2-high asthma patients. Respiratory research 2017; 18: 39 . doi:10.1186/s12931-017-0524-y. doi:986957 de-38m
    CrossrefPubMedGoogle Scholar
  • 70 Zhang Y, Derycke L, Holtappels G. et al Th2 cytokines orchestrate the secretion of MUC5AC and MUC5B in IL-5-positive chronic rhinosinusitis with nasal polyps. Allergy 2018; 74: 131-140 DOI: 10.1111/all.13489. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 71 Bidder T, Sahota J, Rennie C. et al Omalizumab treats chronic rhinosinusitis with nasal polyps and asthma together-a real life study. Rhinology 2018; 56: 42-45 DOI: 10.4193/Rhin17.139. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 72 Green RH, Brightling CE, Woltmann G. et al Analysis of induced sputum in adults with asthma: identification of subgroup with isolated sputum neutrophilia and poor response to inhaled corticosteroids. Thorax 2002; 57: 875-879 DOI: 10.1136/thorax.57.10.875. . doi:283139 de-38m
    CrossrefPubMedGoogle Scholar
  • 73 GINA. Global Strategy for Asthma Management and Prevention (2019 update). 2019 www.ginasthma.org
    Google Scholar
  • 74 Orlandi RR, Kingdom TT, Hwang PH. et al International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. International forum of allergy & rhinology 2016; 6 (Suppl. 01) S22-209 DOI: 10.1002/alr.21695. . doi:868989 de-38m
    CrossrefPubMedGoogle Scholar
  • 75 Pundir V, Pundir J, Lancaster G. et al Role of corticosteroids in Functional Endoscopic Sinus Surgery – a systematic review and meta-analysis. Rhinology 2016; 54: 3-19 DOI: 10.4193/Rhin15.079. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 76 Voorham J, Xu X, Price DB. et al Healthcare resource utilization and costs associated with incremental systemic corticosteroid exposure in asthma. Allergy 2018; 74: 273-283 DOI: 10.1111/all.13556. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 77 Kirsche H, Klimek L. ASS-Intoleranz-Syndrom und persistierende Rhinosinusitis: Differenzialdiagnostik und Therapie. Hno 2015; 63: 357-363 DOI: 10.1007/s00106-015-0008-7. . doi:36872 de-38m
    CrossrefPubMedGoogle Scholar
  • 78 Klimek L, Pfaar O. Aspirin intolerance: does desensitization alter the course of the disease?. Immunology and allergy clinics of North America 2009; 29: 669-675 DOI: 10.1016/j.iac.2009.07.008. . doi:133755 de-38m
    CrossrefPubMedGoogle Scholar
  • 79 Bölke G, Church MK, Bergmann KC. Comparison of extended intervals and dose reduction of omalizumab for asthma control. Allergo Journal International 2019; 28: 1-4 DOI: 10.1007/s40629-018-0087-6.
    CrossrefPubMedGoogle Scholar
  • 80 Ong KY. What’s new in the Global Initiative for Asthma 2018 report and beyond. Allergo Journal International 2019; 28: 63-72 DOI: 10.1007/s40629-018-0079-6.
    CrossrefPubMedGoogle Scholar
  • 81 Raulf M, Sander I, Brüning T. et al Occupational asthma due to tampico fiber bystander exposure in a brush production company — case report and literature review. Allergo Journal International 2019; 28: 73-77 DOI: 10.1007/s40629-018-0085-8.
    CrossrefPubMedGoogle Scholar
  • 82 Hopkins C, Surda P, Bast F. et al Prevention of chronic rhinosinusitis. Rhinology 2018; 56: 307-315 DOI: 10.4193/Rhin17.027. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 83 Kilty SJ, Lasso A, Mfuna-Endam L. et al Case-control study of endoscopic polypectomy in clinic (EPIC) versus endoscopic sinus surgery for chronic rhinosinusitis with polyps. Rhinology 2018; 56: 155-157 DOI: 10.4193/Rhin17.115. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 84 Rudmik L, Soler ZM, Hopkins C. et al Defining appropriateness criteria for endoscopic sinus surgery during management of uncomplicated adult chronic rhinosinusitis: a RAND/UCLA appropriateness study. Rhinology 2016; 54: 117-128 DOI: 10.4193/Rhin16.023. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 85 Gandhi NA, Pirozzi G, Graham NMH. Commonality of the IL-4/IL-13 pathway in atopic diseases. Expert review of clinical immunology 2017; 13: 425-437 DOI: 10.1080/1744666X.2017.1298443. . doi:704218 de-38m
    CrossrefPubMedGoogle Scholar
  • 86 Sanofi-Aventis_Deutschland_GmbH. Dupixent® 300 mg Injektionslösung in einer Fertigspritze, R.L.S. GmbH – Fachinformation. Rote Liste Service GmbH. Frankfurt: 2020: 21
    Google Scholar
  • 87 Forster-Ruhrmann U, Stergioudi D, Pierchalla G. et al Omalizumab in patients with NSAIDs-exacerbated respiratory disease. Rhinology 2020; 58: 226-232 DOI: 10.4193/Rhin19.318. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 88 Ren L, Zhang N, Zhang L. et al Biologics for the treatment of chronic rhinosinusitis with nasal polyps – state of the art. The World Allergy Organization journal 2019; 12: 100050 DOI: 10.1016/j.waojou.2019.100050. . doi:1059287 de-38m
    Google Scholar
  • 89 Tsetsos N, Goudakos JK, Daskalakis D. et al Monoclonal antibodies for the treatment of chronic rhinosinusitis with nasal polyposis: a systematic review. Rhinology 2018; 56: 11-21 DOI: 10.4193/Rhin17.156. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 90 Presta LG, Lahr SJ, Shields RL. et al Humanization of an antibody directed against IgE. Journal of immunology (Baltimore, Md: 1950) 1993; 151: 2623-2632 . doi:60148 de-38m
    CrossrefPubMedGoogle Scholar
  • 91 MacGlashan DW, Bochner BS, Adelman DC. et al Down-regulation of Fc(epsilon)RI expression on human basophils during in vivo treatment of atopic patients with anti-IgE antibody. Journal of immunology (Baltimore, Md: 1950) 1997; 158: 1438-1445 . doi:60148 de-38m
    CrossrefPubMedGoogle Scholar
  • 92 Novartis_Pharma_GmbH. Xolair ® 150 mg Injektionslösung, R.L.S. GmbH – Fachinformation. Rote Liste Service GmbH Frankfurt 2019. p. 9.
    Google Scholar
  • 93 Saini SS, Bindslev-Jensen C, Maurer M. et al Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on H1 antihistamines: a randomized, placebo-controlled study. The Journal of investigative dermatology 2015; 135: 67-75 DOI: 10.1038/jid.2014.306. . doi:56869 de-38m
    CrossrefPubMedGoogle Scholar
  • 94 Pinto JM, Mehta N, DiTineo M. et al A randomized, double-blind, placebo-controlled trial of anti-IgE for chronic rhinosinusitis. Rhinology 2010; 48: 318-324 DOI: 10.4193/Rhino09.144. . doi:341423 de-38m
    CrossrefPubMedGoogle Scholar
  • 95 Gevaert P, Calus L, Van Zele T. et al Omalizumab is effective in allergic and nonallergic patients with nasal polyps and asthma. The Journal of allergy and clinical immunology 2013; 131: 110-116.e111 DOI: 10.1016/j.jaci.2012.07.047. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 96 Romano C, Pace G, Sellitto A. et al Omalizumab as a last resort therapy for intractable, severe chronic allergic rhinosinusitis. Allergo Journal International 2019; 28: 99-102 DOI: 10.1007/s40629-018-0083-x.
    CrossrefPubMedGoogle Scholar
  • 97 Agache I, Rocha C, Beltran J. et al Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines – recommendations on the use of biologicals in severe asthma. Allergy 2020; 75: 1043-1057 DOI: 10.1111/all.14235. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 98 Serrano-Candelas E, Martinez-Aranguren R, Valero A. et al Comparable actions of omalizumab on mast cells and basophils. Clinical and experimental allergy: journal of the British Society for Allergy and Clinical Immunology 2016; 46: 92-102 DOI: 10.1111/cea.12668. . doi:175877 de-38m
    CrossrefPubMedGoogle Scholar
  • 99 Lin H, Boesel KM, Griffith DT. et al Omalizumab rapidly decreases nasal allergic response and FcepsilonRI on basophils. The Journal of allergy and clinical immunology 2004; 113: 297-302 DOI: 10.1016/j.jaci.2003.11.044. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 100 Prussin C, Griffith DT, Boesel KM. et al Omalizumab treatment downregulates dendritic cell FcepsilonRI expression. The Journal of allergy and clinical immunology 2003; 112: 1147-1154 DOI: 10.1016/j.jaci.2003.10.003. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 101 Djukanović R, Wilson SJ, Kraft M. et al Effects of treatment with anti-immunoglobulin E antibody omalizumab on airway inflammation in allergic asthma. American journal of respiratory and critical care medicine 2004; 170: 583-593 DOI: 10.1164/rccm.200312-1651OC. . doi:295090 de-38m
    CrossrefPubMedGoogle Scholar
  • 102 Sahota J, Bidder T, Livingston R. et al Chronic rhinosinusitis and omalizumab: eosinophils not IgE predict treatment response in real-life*. Rhinology Online 2018; 1: 147-153 DOI: 10.4193/RHINOL/18.077.
    CrossrefPubMedGoogle Scholar
  • 103 Roche H-L. A Clinical Trial of Omalizumab in Participants With Chronic Rhinosinusitus With Nasal Polyps (POLYP 2). 2019 In. 09.01.2020 ed. https://clinicaltrials.gov/ct2/show/NCT03280537
    Google Scholar
  • 104 Roche H-L. A Clinical Trial of Omalizumab in Participants With Chronic Rhinosinusitis With Nasal Polyps (POLYP 1). 2019 https://clinicaltrials.gov/ct2/show/NCT03280550
    Google Scholar
  • 105 Gevaert P, Omachi TA, Corren J. et al Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials. The Journal of allergy and clinical immunology 2020; 146: 595-605 DOI: 10.1016/j.jaci.2020.05.032. . doi:37848 de-38m
    CrossrefPubMedGoogle Scholar
  • 106 DeutschesArztportal. Der Ratgeber zur wirtschaftlichen Verordnung – Rabattvertrags-Check. In. DeutschesArztportal; 2021
    Google Scholar
  • 107 Bachert C, Gevaert P, Hellings P. Biotherapeutics in Chronic Rhinosinusitis with and without Nasal Polyps. The journal of allergy and clinical immunology In practice 2017; 5: 1512-1516 DOI: 10.1016/j.jaip.2017.04.024. . doi:917835 de-38m
    CrossrefPubMedGoogle Scholar
  • 108 Kim DW, Cho SH. Emerging Endotypes of Chronic Rhinosinusitis and Its Application to Precision Medicine. Allergy, asthma & immunology research 2017; 9: 299-306 DOI: 10.4168/aair.2017.9.4.299. . doi:822656 de-38m
    CrossrefPubMedGoogle Scholar
  • 109 Untersmayr E, Förster-Waldl E, Bonelli M. et al Immunologisch relevante Aspekte der neuen COVID-19-Impfstoffe: Ein Positionspapier der Österreichischen Gesellschaft für Allergologie und Immunologie (ÖGAI) und des Ärzteverbands Deutscher Allergologen (AeDA). Allergo Journal: interdisziplinare Zeitschrift fur Allergologie und Umweltmedizin: Organ der Deutschen Gesellschaft fur Allergie- und Immunitatsforschung 2021; 30: 34-47 DOI: 10.1007/s15007-021-4848-z. . doi:317060 de-38m
    CrossrefPubMedGoogle Scholar
  • 110 Altrichter S, Wöhrl S, Horak F. et al Answers to burning questions for clinical allergologists related to the new COVID-19 vaccines. Allergo journal international 2021; 1-7 DOI: 10.1007/s40629-021-00177-3.
    CrossrefPubMedGoogle Scholar
  • 111 Klimek L, Pfaar O, Worm M. Anwendung von Biologika bei allergischen und Typ-2-entzündlichen Erkrankungen in der aktuellen COVID-19-Pandemie – ein Positionspapier von AeDA, DGAKI, GPA, ÖGAI, LGAI, ÖGP, ARIA und EAACI. Use of biologicals in allergic and type-2 inflammatory diseases in times of the current COVID-19 pandemic – Position paper of AeDA, DGAKI, GPA, ÖGAI, LGAI, ÖGP, ARIA und EAACI. Allergologie 2020; 43: 255 . doi:50376 de-38m
    CrossrefPubMedGoogle Scholar
  • 112 Riggioni C, Comberiati P, Giovannini M. et al A compendium answering 150 questions on COVID-19 and SARS-CoV-2. Allergy 2020; 75: 2503-2541 DOI: 10.1111/all.14449. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 113 Dorsch W, Ring J. Anti-inflammatory substances from onions could be an option for treatment of COVID-19-a hypothesis. Allergo journal international 2020; 29: 284-285 DOI: 10.1007/s40629-020-00146-2.
    CrossrefPubMedGoogle Scholar
  • 114 Jakob T, Klimek L. Allergologie in Zeiten von COVID-19. Allergo Journal 2020; 29: 3-3 DOI: 10.1007/s15007-020-2538-x. . doi:317060 de-38m
    CrossrefPubMedGoogle Scholar
  • 115 Klimek L, Bergmann KC, Brehler R. et al Praktischer Umgang mit allergischen Reaktionen auf COVID-19-Impfstoffe: Ein Positionspapier des Ärzteverbands Deutscher Allergologen (AeDA), der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAKI), der Gesellschaft für Pädiatrische Allergologie und Umweltmedizin (GPA) und der Österreichischen Gesellschaft für Allergologie und Immunologie (ÖGAI). Allergo Journal: interdisziplinare Zeitschrift fur Allergologie und Umweltmedizin: Organ der Deutschen Gesellschaft fur Allergie- und Immunitatsforschung 2021; 30: 22-43 DOI: 10.1007/s15007-021-4773-1. . doi:317060 de-38m
    CrossrefPubMedGoogle Scholar
  • 116 Klimek L, Jutel M, Akdis C. et al Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI statement. Allergy 2020; 75: 1546-1554 DOI: 10.1111/all.14336. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar
  • 117 Klimek L, Novak N, Hamelmann E. et al Schwere allergische Reaktionen nach COVID-19-Impfung mit dem Impfstoff von Pfizer/BioNTech in Großbritannien und USA: Stellungnahme der deutschen allergologischen Gesellschaften AeDA (Ärzteverband Deutscher Allergologen), DGAKI (Deutsche Gesellschaft für Allergologie und klinische Immunologie) und GPA (Gesellschaft für Pädiatrische Allergologie und Umweltmedizin). Allergo Journal: interdisziplinare Zeitschrift fur Allergologie und Umweltmedizin: Organ der Deutschen Gesellschaft fur Allergie- und Immunitatsforschung 2021; 30: 24-29 DOI: 10.1007/s15007-021-4762-4. . doi:317060 de-38m
    CrossrefPubMedGoogle Scholar
  • 118 Klimek L, Pfaar O, Worm M. et al Allergen-Immuntherapie in der aktuellen COVID-19-Pandemie. Allergo Journal 2020; 29: 17-25 DOI: 10.1007/s15007-020-2539-9. . doi:317060 de-38m
    CrossrefPubMedGoogle Scholar
  • 119 Klimek L, Worm M, Lange L. et al Management von Anaphylaxie-gefährdeten Patienten wahrend der COVID-19-Pandemie: Ein Positionspapier des Arzteverbandes Deutscher Allergologen (AeDA)A, der Deutschen Gesellschaft fur Allergologie und klinische Immunologie (DGAKI)B, der Gesellschaft fur Padiatrische Allergologie und Umweltmedizin (GPA)C und des Deutschen Allergie- und Asthmabundes (DAAB)D. WHO; 2020
    Google Scholar
  • 120 Pfaar O, Klimek L, Hamelmann E. et al COVID-19-Impfungen von Patienten mit Allergien und Typ2-entzündlichen Erkrankungen bei gleichzeitiger Antikörpertherapie (Biologika): Ein Positionspapier der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAKI) und dem Ärzteverband Deutscher Allergologen (AeDA). Allergo Journal: interdisziplinare Zeitschrift fur Allergologie und Umweltmedizin: Organ der Deutschen Gesellschaft fur Allergie- und Immunitatsforschung 2021; 30: 24-33 DOI: 10.1007/s15007-021-4846-1. . doi:317060 de-38m
    CrossrefPubMedGoogle Scholar
  • 121 Pfaar O, Klimek L, Jutel M. et al COVID-19 pandemic: Practical considerations on the organization of an allergy clinic-An EAACI/ARIA Position Paper. Allergy 2020; 76: 648-676 DOI: 10.1111/all.14453. . doi:343917 de-38m
    CrossrefPubMedGoogle Scholar