Page 79 - Portuguese Journal - SPORL - Vol 61. Nº1

Table 3
Criteria for the use of biological therapy in patients with chronic rhinosinusitis with nasal polyps

Presence of bilateral nasal Presence of bilateral nasal
Criteria polyps with history polyps without history
of previous surgery of previous surgery
- Type 2 inflammation
- At least 2 courses of systemic glucocorticoids
in the last year
- Significant impact on the quality of life 3 criteria required 4 criteria required
- Significant loss of the sense of smell
- Diagnosis of asthma

Table 4
Criteria and classification of the response of patients with chronic rhinosinusitis with nasal polyps to
biological therapy

Criteria Classification
- Reduction in the size of the nasal polyps 0 criteria – without response;
- Reduction in the need for systemic glucocorticoids 1-2 criteria – poor response;
- Increase in the quality of life
- Improvement in the sense of smell 3-4 criteria – good response;
- Reduction in the impact of comorbidities 5 criteria – excellent response;

bilateral nasal polyps and three or four of Conflicts of Interest
the criteria presented in Table 3 depending The authors declare that there is no conflict
on the presence or absence of previous of interests regarding the publication of this
surgery, respectively 35 . However, when a paper.
biologic is used for treatment, it is essential
to assess the patient’s response to avoid Data Confidentiality
inappropriate treatments and unnecessary The authors declare having followed the
costs. Thus, in that meeting, it was proposed protocols in use at their working center
that for a response to biological therapy to be regarding patients’ data publication.
considered acceptable, the response to the
five criteria (Table 4) needs to be assessed Protection of humans and animals
one year after the treatment. This response is The authors declare that the procedures
classified according to the number of criteria were followed according to the regulations
that are met (see Table 4) and the treatment established by the Clinical Research and Ethics
is discontinued if there is no response to it . Committee and to the 2013 Helsinki Declaration
35
of the World Medical Association.
Conclusion
In this systematic review, dupilumab was Funding Sources
found to be the monoclonal antibody with This work did not receive any contribution,
the most impact, both on the quality of life funding or scholarship.
and disease extension. Further studies are
necessary to better evaluate the long-term Availability of scientific data
effect of these new therapies. However, There are no datasets available, publicly related
given the costs inherent to their application, to this work.
it is imperative to perform an effective and
efficient assessment of which patients would
benefit the most from biologics.

Volume 61 . Nº1 . March 2023 79