Sevgi ÇOLAK, Mustafa ÇOLAK, Dilşad MUNGAN

Astım ve nazal polipozis: Biyolojik tedaviler etkili mi?

Ağır astım hastalığına nazal polipli kronik rinosinüzit sıklıkla eşlik etmektedir. Kontrolsüz nazal polip varlığı, tek başına hayat kalitesini bozmakla kalmayıp, eşlik eden astım hastalığının kontrolünü de zorlaştırmaktadır. Tip 2 inflamasyonun hakim olduğu eozinofilik kronik sinüzit, fenotipik olarak nazal poliple kendini göstermektedir. Son yıllarda astım hastalığında olduğu gibi kronik sinüzit hastalarında da fenotip ve endotipe yönelik yaklaşımlar gelişmekte olup; uygun endotipe sahip kontrolsüz hastalarda biyolojik tedaviler gündeme gelmektedir. Bu hastalarda Ig-E, IL-5 ve IL-4α yolaklarını antagonize eden tedaviler ile ilgili son yıllarda yapılan randomize kontrollü çalışmalar yüz güldürücüdür. Yakın gelecekte nazal polip hastalarının yönetiminde klinik pratiğe daha çok dahil olacağını düşündüğümüz biyolojik tedavilerin etkinlikleri, gerçek yaşam verilerinin literatürde artmasıyla netlik kazanacaktır

Asthma and nasal polyposis: Are biological treatments effective?

Chronic rhinosinusitis with nasal polyps often accompanies severe asthma. Uncontrolled nasal polyp does not only impair the quality of life, but also makes it difficult to control the accompanying asthma. Eosinophilic chronic sinusitis dominated by type 2 inflammation is phenotypically manifested by nasal polyps. In recent years, approaches towards phenotype and endotype have developed in patients with chronic sinusitis as well as in asthma; biological treatments come into question in uncontrolled patients with appropriate endotype. Randomized controlled trials conducted on treatments that antagonize the Ig-E, IL-5, and IL-4a pathways in these patients are promising. The effectiveness of biological treatments, which we think will be more involved in clinical practice in the management of nasal polyp patients in the near future, will become clear with the increase in real life data in the literature.

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