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Schneider AL, Schleimer RP, Tan BK. Targetable pathogenic mechanisms in nasal polyposis. Int Forum Allergy Rhinol 2021; 11:1220-1234. [PMID: 33660425 DOI: 10.1002/alr.22787] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) represents a challenging disease entity with significant rates of recurrence following appropriate medical and surgical therapy. Recent approval of targeted biologics in CRSwNP compels deeper understanding of underlying disease pathophysiology. Both of the approved biologics for CRSwNP modulate the type 2 inflammatory pathway, and the majority of drugs in the clinical trials pathway are similarly targeted. However, there remain multiple other pathogenic mechanisms relevant to CRSwNP for which targeted therapeutics already exist in other inflammatory diseases that have not been studied directly. In this article we summarize pathogenic mechanisms of interest in CRSwNP and discuss the results of ongoing clinical studies of targeted therapeutics in CRSwNP and other related human inflammatory diseases.
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Affiliation(s)
| | - Robert P Schleimer
- Department of Otolaryngology, Head and Neck Surgery, Chicago, Illinois, USA.,Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bruce K Tan
- Department of Otolaryngology, Head and Neck Surgery, Chicago, Illinois, USA.,Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Azzano P, Dufresne É, Poder T, Bégin P. Economic considerations on the usage of biologics in the allergy clinic. Allergy 2021; 76:191-209. [PMID: 32656802 DOI: 10.1111/all.14494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 12/27/2022]
Abstract
The advent of biologic therapies has transformed care for severe atopic disorders but their high cost poses new challenges with regard to long-term sustainability and fair allocation of resources. This article covers the basic concepts of cost-utility analyses and reviews the available literature on cost utility of biologic drugs in atopic disorders. When used within their limits as part of a multi-dimensional assessment, economic analyses can be extremely useful to guide decision-making and prioritization of care. Despite the good quality of most cost-utility analyses conducted for the use of biologics in asthma and other atopic diseases, their conclusions regarding cost-effectiveness are extremely variable. This is mainly due to the use of inconsistent estimates of health utility benefit with therapy. Development of reliable and validated instruments to measure disutility in atopic disorders and measure of indirect costs in atopic disease are identified as a priority for future research.
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Affiliation(s)
- Pauline Azzano
- Department of Pediatrics CHU Sainte‐Justine Montreal QC Canada
| | - Élise Dufresne
- Department of Pediatrics CHU Sainte‐Justine Montreal QC Canada
| | - Thomas Poder
- Department of Management, Evaluation and Health Policy School of Public Health University of Montreal Montreal QC Canada
- Research Center of the Institut Universitaire en Santé Mentale de Montréal Montreal QC Canada
| | - Philippe Bégin
- Department of Pediatrics CHU Sainte‐Justine Montreal QC Canada
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Mainland JD, Barlow LA, Munger SD, Millar SE, Vergara MN, Jiang P, Schwob JE, Goldstein BJ, Boye SE, Martens JR, Leopold DA, Bartoshuk LM, Doty RL, Hummel T, Pinto JM, Trimmer C, Kelly C, Pribitkin EA, Reed DR. Identifying Treatments for Taste and Smell Disorders: Gaps and Opportunities. Chem Senses 2020; 45:493-502. [PMID: 32556127 PMCID: PMC7545248 DOI: 10.1093/chemse/bjaa038] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The chemical senses of taste and smell play a vital role in conveying information about ourselves and our environment. Tastes and smells can warn against danger and also contribute to the daily enjoyment of food, friends and family, and our surroundings. Over 12% of the US population is estimated to experience taste and smell (chemosensory) dysfunction. Yet, despite this high prevalence, long-term, effective treatments for these disorders have been largely elusive. Clinical successes in other sensory systems, including hearing and vision, have led to new hope for developments in the treatment of chemosensory disorders. To accelerate cures, we convened the "Identifying Treatments for Taste and Smell Disorders" conference, bringing together basic and translational sensory scientists, health care professionals, and patients to identify gaps in our current understanding of chemosensory dysfunction and next steps in a broad-based research strategy. Their suggestions for high-yield next steps were focused in 3 areas: increasing awareness and research capacity (e.g., patient advocacy), developing and enhancing clinical measures of taste and smell, and supporting new avenues of research into cellular and therapeutic approaches (e.g., developing human chemosensory cell lines, stem cells, and gene therapy approaches). These long-term strategies led to specific suggestions for immediate research priorities that focus on expanding our understanding of specific responses of chemosensory cells and developing valuable assays to identify and document cell development, regeneration, and function. Addressing these high-priority areas should accelerate the development of novel and effective treatments for taste and smell disorders.
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Affiliation(s)
| | - Linda A Barlow
- Department of Cell & Developmental Biology, Rocky Mountain Taste and Smell Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Steven D Munger
- Center for Smell and Taste, Department of Pharmacology and Therapeutics, 1200 Newell Drive, University of Florida, Gainesville, FL, USA
| | - Sarah E Millar
- Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Natalia Vergara
- Department of Ophthalmology, Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora, CO, USA
| | - Peihua Jiang
- Monell Chemical Senses Center, Philadelphia, PA, USA
| | - James E Schwob
- Department of Developmental, Molecular and Chemical Biology, Tufts University School of Medicine, Boston, MA, USA
| | - Bradley J Goldstein
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, 40 Duke Medicine Cir Clinic 1F, Durham, NC, USA
| | - Shannon E Boye
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jeffrey R Martens
- Center for Smell and Taste, Department of Pharmacology and Therapeutics, 1200 Newell Drive, University of Florida, Gainesville, FL, USA
| | - Donald A Leopold
- Division of Otolaryngology Head and Neck Surgery, University of Vermont Medical Center, Burlington, VT, USA
| | - Linda M Bartoshuk
- Department of Food Science and Human Nutrition, Center for Smell and Taste, University of Florida, Gainesville, FL, USA
| | - Richard L Doty
- Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, 3400 Spruce Street, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Fetscherstrasse, Dresden, Germany
| | - Jayant M Pinto
- Section of Otolaryngology—Head and Neck Surgery, Department of Surgery, The University of Chicago, MC, Chicago, IL, USA
| | | | | | - Edmund A Pribitkin
- Department of Otolaryngology—Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA
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