British Rhinological Society Consensus Guidance on the use of biological
therapies for Chronic Rhinosinusitis with Nasal Polyps
Abstract
Objectives We set out to create Consensus Guidelines, based on current
evidence and relative risks of adverse effects and the costs of
different treatments, that reflect the views of the British Rhinological
Society (BRS) Council on where the use of biologics should be positioned
within treatment pathways for CRSwNP, specifically in the setting of the
National Health Service (NHS). Methods An expert panel of 16 members was
assembled. A review of the literature and evidence synthesis was
undertaken and circulated to the panel We used the RAND/UCLA methodology
with a multi-step process to make recommendations on the use of
biologics. Setting and participants N/A Results Recommendations were
made, based on underlying disease severity, prior treatments and
co-morbidities. A group of patients for whom biologics were considered
an appropriate treatment option for CRSwNP was defined. Conclusions
Although biologics are not currently available for the treatment of
CRSwNP, the BRS Council have defined a group of patients who have higher
rates of ‘failure’ with current treatment pathways, higher resource use
and are more likely to suffer with uncontrolled symptoms. We would urge
NICE to consider approval of biologics for such indications without
applying further restrictions on use.