Table 3 Results of the Delphi survey Section 3: follow-up
Number | Statement | Median | Appropriateness | Consensus/ round |
|---|---|---|---|---|
1 | Biomarkers associated with type 2 inflammation that are useful for the follow-up of patients with severe asthma and CRSwNP treated with biologics are: | |||
1.1 | Peripheral blood eosinophil count | 8 | Appropriate | Yes/1st |
1.2 | Tissue eosinophil count (sputum, nasal polyp biopsy, bronchial biopsy) | 8 | Appropriate | Yes/1st |
1.3 | FeNO | 8 | Appropriate | Yes/1st |
1.4 | Serum total IgE | 7.5 | Appropriate | No (controversy)/2nd |
1.5 | Specific IgE (in serum or by intra-epidermal test or Prick test) | 5 | Uncertain | No (controversy)/2nd |
2 | In patients with severe type asthma and CRSwNP, it is recommended to record the following biomarkers to monitor the response to treatment with biologics: | |||
2.1 | Serum total IgE | 8 | Appropriate | No (controversy)/2nd |
2.2 | Peripheral blood eosinophil count | 8 | Appropriate | Yes/1st |
2.3 | Tissue eosinophil count (in nasal polyps) | 8 | Appropriate | Yes/2nd |
2.4 | FeNO | 8 | Appropriate | Yes/1st |
3 | The same biomarkers and clinical criteria used at the time of biologic prescription should be used to monitor these patients. | 8 | Appropriate | Yes/1st |
4 | In patients with type 2 asthma (severe) and CRSwNP on biologics, the presence of elevated FeNO increases the risk of developing exacerbations. | 7 | Appropriate | Yes/2nd |
5 | In patients with severe type 2 asthma and CRSwNP, any professional, regardless of their specialty, must be aware of the results of the different biomarkers and clinical markers of both diseases to ensure correct management. | 9 | Appropriate | Yes/1st |
6 | In patients with type 2 CRSwNP (severe) and asthma, the following biomarkers and clinical markers determine the lack of response to ESS and thus recurrence of CRSwNP: | |||
6.1 | Tissue eosinophil count | 8 | Appropriate | Yes/1st |
6.2 | Peripheral blood eosinophil count | 7 | Appropriate | No (controversy)/2nd |
6.3 | Anosmia (by VAS or smell test) | 8 | Appropriate | Yes/1st |
6.4 | Quality of life (SNOT-22) | 8 | Appropriate | Yes/1st |
7 | The optimal time for assessing response to a biologic in patients with severe type 2 asthma and CRSwNP is 12 months. | 8 | Appropriate | Yes/2nd |
8 | The minimum time for assessing response to a biologic in patients with severe type 2 asthma and CRSwNP is 6 months. | 9 | Appropriate | Yes/1st |