Airing It Out
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis
A man with nasal polyposis
A young man with severe asthma
A woman with asthma and nasal polyposis
Asthma
Efficacy and safety of benralizumab for patients with severe asthma uncontrolled with high-dosage inhaled corticosteroids and long-acting β2-agonists (SIROCCO): a randomised, multicentre, placebo-controlled phase 3 trial.
Bleecker ER, et al. Lancet. 2016;388(10056):2115-2127.
Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma.
Castro M, et al. N Engl J Med. 2018;378(26):2486-2496.
Liberty Asthma QUEST: phase 3 randomized, double-blind, placebo-controlled, parallel-group study to evaluate dupilumab efficacy/safety in patients with uncontrolled, moderate-to-severe asthma.
Busse WW, et al. Adv Ther. 2018;35(5):737-748.
Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials.
Castro M, et al. Lancet Respir Med. 2015;3(5):355-366.
Tezepelumab in adults with uncontrolled asthma.
Corren J, et al. N Engl J Med. 2017;377(10):936-946.
A review of anti-IgE monoclonal antibody (omalizumab) as add on therapy for severe allergic (IgE-mediated) asthma.
D’Amato G, et al. Ther Clin Risk Manag. 2007;3(4):613-619.
Inflammatory and comorbid features of patients with severe asthma and frequent exacerbations.
Denlinger LC, et al. Am J Respir Crit Care Med. 2017;195(3):302-313.
Fevipiprant, a prostaglandin D2 receptor 2 antagonist, in patients with persistent eosinophilic asthma: a single-centre, randomised, double-blind, parallel-group, placebo-controlled trial.
Gonem S, et al. Lancet Respir Med. 2016;4(9):699-707.
Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial.
FitzGerald JM, et al. Lancet. 2016;388(10056):2128-2141.
Severe and difficult-to-treat asthma in adults.
Israel E, Reddel HK. N Engl J Med. 2017;377(10):965-976.
Biologic agents for the treatment of chronic rhinosinusitis with nasal polyps.
Kartush AG, et al. Am J Rhinol Allergy. 2019;33(2):203-211.
Adult asthma biomarkers.
Kim MA, et al. Curr Opin Allergy Clin Immunol. 2014;14(1):49-54.
Predictive biomarkers for asthma therapy.
Medrek SK, et al. Curr Allergy Asthma Rep. 2017;17(10):69.
Mepolizumab treatment in patients with severe eosinophilic asthma.
Ortega HG, et al. N Engl J Med. 2014;371(13):1198-1207.
Severe eosinophilic asthma treated with mepolizumab stratified by baseline eosinophil thresholds: a secondary analysis of the DREAM and MENSA studies.
Ortega HG, et al. Lancet Respir Med. 2016;4(7):549-556.
Allergen immunotherapy in asthma; what is new?
Passalacqua G, et al. Asthma Res Pract. 2015;1:6.
Asthma Yardstick: practical recommendations for a sustained step-up in asthma therapy for poorly controlled asthma.
Chipps BE, et al. Ann Allergy Asthma Immunol. 2017;118:133-142.
Co-morbidities in severe asthma: clinical impact and management.
Porsbjerg C, Menzies-Gow A. Respirology. 2017;22(4):651-661.
Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma.
Rabe KF, et al. N Engl J Med. 2018;378(26):2475-2485.
Effect of subcutaneous dupilumab on nasal polyp burden in patients with chronic sinusitis and nasal polyposis: a randomized clinical trial.
Bachert C, et al. JAMA. 2016;315(5):469-749.
Suggested Readings
CRSwNP
Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials.
Bachert C, et al. Lancet. 2019;394(10209):1638-1650.
Effect of subcutaneous dupilumab on nasal polyp burden in patients with chronic sinusitis and nasal polyposis: a randomized clinical trial.
Bachert C, et al. JAMA. 2016;315(5):469-479.
Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology.
Dietz de Loos D, et al. J Allergy Clin Immunol. 2019;143(3):1207-1214.
Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps.
Bhattacharyya N, et al. Laryngoscope. 2019:129(9):1969-1975.
Endotypes and phenotypes of chronic rhinosinusitis: a PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology.
Akdis CA, et al. J Allergy Clin Immunol. 2013;131(6):1479-1490.
A phase 3 trial of mometasone furoate sinus implants for chronic sinusitis with recurrent nasal polyps.
Kern RC, et al. Int Forum Allergy Rhinol. 2018;8(4):471–481.
NAVIGATE II: Randomized, double-blind trial of the exhalation delivery system with fluticasone for nasal polyposis.
Leopold DA, et al. J Allergy Clin Immunol.
Current trends in topical therapies for chronic rhinosinusitis: update and literature review.
Varshney R, Lee JT. Expert Opin Drug Deliv. 2017;14(2):257-271.
Efficacy of fluticasone exhalation delivery system in the management of chronic rhinosinusitis: what is the evidence?
Kuan EC, et al. Int Forum Allergy Rhinol. 2019;9(S1):S16–S21.
Handouts
Helping Patients Understand Biologic Therapy for CRSwNP
Helping Patients Understand Biologic Therapy for Poorly Controlled Asthma
Clinical Practice Guidelines
Difficult-to-treat and severe asthma in adolescent and adult patients: diagnosis and management.
Global Initiative for Asthma.
International ERS/ATS Guidelines on Definition, Evaluation and Treatment of Severe Asthma.
Chung KF, et al. Eur Respir J. 2014;43(2):343-373.
An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications.
Dweik RA, et al. Am J Respir Crit Care Med. 2011;184(5):602-615.
International consensus statement on allergy and rhinology: rhinosinusitis.
Orlandi RR, et al. Int Forum Allergy Rhinol. 2016;6(suppl 1):S22-S209.
American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guideline (update): adult sinusitis.
Rosenfeld RM, et al. Otolaryngol Head Neck Surg. 2015;152(2 suppl):S1-S39.
EUFOREA consensus on biologics for CRSwNP with or without asthma.
Fokkens WJ, et al. Allergy. 2019;74(12):2312-2319.
Chronic rhinosinusitis with nasal polyps.
Hopkins C. N Engl J Med. 2019;381:55-63.
Patient Resources
Asthma and Allergy Foundation of America (AAFA)
AAFA is dedicated to improving the quality of life for people with asthma and allergic diseases through education, advocacy, and research.
American College of Allergy, Asthma & Immunology (ACAAI)
The ACAAI fosters a culture of collaboration and congeniality in which members work toward the common goals of patient care, education, advocacy, and research.
American Lung Association
The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through education, advocacy, and research.
American Thoracic Society (ATS)
The mission of the ATS is to improve health worldwide by advancing research, clinical care, and public health in respiratory disease, critical illness, and sleep disorders.
Centers for Disease Control and Prevention (CDC) Asthma Action Plans
These tools for asthma control were created following the evidence-based guidance published by the National Institutes of Health.
Chest Foundation
The CHEST Foundation creates trusted patient education resources and disease awareness campaigns that empower patients to engage in better managing their health.
Clinical Assessment Tools
Asthma Control Test (ACT)
This 5-question test evaluates asthma control over the past 4 weeks on a 5-point Likert scale. A score of <20 on the ACT suggests asthma that is uncontrolled. Nathan RA, et al. J Allergy Clin Immunol. 2004;113(1):59-65.
Asthma Control Questionnaire (ACQ)
This 7-question assessment tool measures asthma control over the past 7 days. Six questions are self-administered by the patient, and 1 question requires a clinician’s input. Scores range from 1 (totally controlled) to 6 (severely uncontrolled). Juniper EF, et al. Eur Respir J. 1999;14(4):902-907.
Asthma Therapy Assessment Questionnaire (ATAQ)
This 4-question test assesses asthma control over the past 4 weeks. Each question has a possible score of 0 or 1; if the sum of the 4 question scores is >1, the patient’s asthma may be uncontrolled. Vollmer WM, et al. Am J Respir Crit Care Med. 1999;160(5 Pt 1):1647-1652.
Shared Decision-Making Tool
CHEST Foundation, Allergy and Asthma Network, ACAAI
A tool for patients and clinicians to work together to improve self-management skills, choose the best treatment plan, and increase adherence.
Airing It Out
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyps
| Faculty: | Joseph K. Han, MD, FARS, FAAOA; John J. Oppenheimer, MD; Reynold A. Panettieri, Jr, MD |
| Release: | 08/21/2020 |
| Expiration: | 08/21/2021 |
