Claire Hopkins1, Jo-Lyn McKenzie2, Shahram Anari3, Sean Carrie4, Yujay Ramakrishnan5, Naveed Kara6, Carl Philpott7, Jonathan Hobson8, Ali Qureishi9, Ben Stew10, Raj Bhalla8, Simon Gane11, Abigail Walker12, Phil Harries13, Iain Hathorn14, Valerie Lund15. 1. Guy's and St Thomas' Hospitals, London, UK. 2. Guy's and Hospitals, Royal Brisbane and Women's Hospital, Herston, QLD, Australia. 3. University Hospitals Birmingham NHS Trust, Birmingham, UK. 4. Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK. 5. Nottingham University Hospital, Nottingham, UK. 6. County Durham & Darlington NHS Foundation Trust, Darlington, UK. 7. Norwich Medical School, University of East Anglia, Norwich, UK. 8. Manchester University NHS Foundation Trust, Manchester, UK. 9. Oxford University Hospitals, Oxford, UK. 10. University Hospital Wales, Cardiff, UK. 11. The Royal National Throat Nose and Ear Hospital, London, UK. 12. Rhinology Fellow St George's Hospital, London, UK. 13. University Hospital Southampton, Southampton, UK. 14. University of Edinburgh, Edinburgh, UK. 15. Royal National Throat, Nose and Ear Hospital, UCLH Foundation Trust, London, UK.
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, which 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). DESIGN: 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: N/A. 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.
OBJECTIVES: We set out to create Consensus Guidelines, based on current evidence and relative risks of adverse effects and the costs of different treatments, which 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). DESIGN: 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: N/A. 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.