Abstract：
OBJECTIVE: To compare international and regional guidelines for prescription and monitoring of response to biologics in chronic rhinosinusitis with nasal polyps (CRSwNP).
METHODS: A literature review was performed to identify publications reporting indications for biologic therapy in CRSwNP. A full-text reading identified specific issues for comparison: prior surgery, evidence of type 2 inflammation (T2I), smell function, comorbidities, use of systemic corticosteroids, impact on quality of life, and endoscopic and CT findings were compared for the prescription, while the monitoring of the treatment was described in relation to timing, classification of response and criteria for withdrawal.
RESULTS: Ten publications were found. Prior surgery was strictly necessary in five guidelines, while in all the remaining it was variably recommended. A confirmation of T2I was considered necessary in one publication, unnecessary in two, and recommended or constituted only one of the factors to consider in seven. All the other issues analyzed were variably considered. Reevaluation was suggested at 4-6 months and 1 year, mostly assessing improvement in the same criteria used for prescription.
CONCLUSIONS: A combination of subjective and objective findings is used for the identification of patients with CRSwNP who are indicated for biologic therapy. Major debate has developed on the need for previous surgery, which is generally recommended, or strictly necessary for some authors. Confirmation of T2I is generally suggested, but compulsory only in a minority of guidelines. Smell function, use of systemic corticosteroids, and the impact on quality of life are the other factors most frequently considered.
METHODS: A literature review was performed to identify publications reporting indications for biologic therapy in CRSwNP. A full-text reading identified specific issues for comparison: prior surgery, evidence of type 2 inflammation (T2I), smell function, comorbidities, use of systemic corticosteroids, impact on quality of life, and endoscopic and CT findings were compared for the prescription, while the monitoring of the treatment was described in relation to timing, classification of response and criteria for withdrawal.
RESULTS: Ten publications were found. Prior surgery was strictly necessary in five guidelines, while in all the remaining it was variably recommended. A confirmation of T2I was considered necessary in one publication, unnecessary in two, and recommended or constituted only one of the factors to consider in seven. All the other issues analyzed were variably considered. Reevaluation was suggested at 4-6 months and 1 year, mostly assessing improvement in the same criteria used for prescription.
CONCLUSIONS: A combination of subjective and objective findings is used for the identification of patients with CRSwNP who are indicated for biologic therapy. Major debate has developed on the need for previous surgery, which is generally recommended, or strictly necessary for some authors. Confirmation of T2I is generally suggested, but compulsory only in a minority of guidelines. Smell function, use of systemic corticosteroids, and the impact on quality of life are the other factors most frequently considered.
摘要：
目的：比较慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）中生物制剂处方和反应监测的国际和地区指南。
方法：进行了文献综述，以确定报告CRSwNP生物治疗适应症的出版物。全文阅读确定了具体问题进行比较：以前的手术，2型炎症（T2I）的证据，嗅觉功能,合并症,使用全身性皮质类固醇，对生活质量的影响，并比较了处方的内镜和CT检查结果，虽然对治疗的监测与时机有关，反应分类和戒断标准。
结果：共发现10篇出版物。在五项指南中，先前的手术是绝对必要的，而在所有剩余的建议是可变的。在一份出版物中，T2I的确认被认为是必要的，不必要的两个，并推荐或仅构成七个要考虑的因素之一。分析的所有其他问题都得到了不同的考虑。建议在4-6个月和1年进行重新评估，主要是评估处方标准的改善情况。
结论：主观和客观结果的组合被用于确定接受生物治疗的CRSwNP患者。关于以前手术的必要性已经展开了重大辩论，这是一般推荐的，或者对某些作者来说是绝对必要的。通常建议确认T2I，但只有少数准则是强制性的。嗅觉功能,使用全身性皮质类固醇，对生活质量的影响是其他最常考虑的因素。
方法：进行了文献综述，以确定报告CRSwNP生物治疗适应症的出版物。全文阅读确定了具体问题进行比较：以前的手术，2型炎症（T2I）的证据，嗅觉功能,合并症,使用全身性皮质类固醇，对生活质量的影响，并比较了处方的内镜和CT检查结果，虽然对治疗的监测与时机有关，反应分类和戒断标准。
结果：共发现10篇出版物。在五项指南中，先前的手术是绝对必要的，而在所有剩余的建议是可变的。在一份出版物中，T2I的确认被认为是必要的，不必要的两个，并推荐或仅构成七个要考虑的因素之一。分析的所有其他问题都得到了不同的考虑。建议在4-6个月和1年进行重新评估，主要是评估处方标准的改善情况。
结论：主观和客观结果的组合被用于确定接受生物治疗的CRSwNP患者。关于以前手术的必要性已经展开了重大辩论，这是一般推荐的，或者对某些作者来说是绝对必要的。通常建议确认T2I，但只有少数准则是强制性的。嗅觉功能,使用全身性皮质类固醇，对生活质量的影响是其他最常考虑的因素。
