Uso de Terapias Biológicas (anticorpos Monoclonais) em Rinossinusite Crônica com Polipose Nasal
DOI:
https://doi.org/10.36489/nursing.2025v30i328p11699-11710Palavras-chave:
Rinossinusite Crônica, Pólipos Nasais, Anticorpos MonoclonaisResumo
Introdução: A rinossinusite crônica com polipose nasal (RSCPN) frequentemente cursa com inflamação tipo 2 e alta taxa de recidiva após corticoide sistêmico e/ou cirurgia endoscópica. Biológicos dirigidos a alvos como IgE, IL-4/IL-13, IL-5/IL-5R e TSLP emergiram como opções efetivas. Objetivo: Sintetizar a evidência sobre eficácia, segurança, indicações e monitoramento de anticorpos monoclonais na RSCPN. Métodos: Revisão narrativa de literatura (PubMed, SciELO e Web of Science) até 14/10/2025, priorizando ensaios clínicos fase III, consensos/guidelines e estudos do “mundo real”. Resultados: Dupilumabe (anti-IL-4Rα) reduziu escore de pólipos nasais (NPS), congestão e opacificação sinusal em dois RCTs de fase III (SINUS-24/52) e melhora persiste em subgrupos com/sem asma; omalizumabe (anti-IgE) mostrou melhora endoscópica e de sintomas (POLYP-1/2) e foi aprovado como terapia adjuvante; mepolizumabe (anti-IL-5) reduziu NPS e necessidade de cirurgia (SYNAPSE); benralizumabe (anti-IL-5Rα) melhorou NPS, congestão e olfato (OSTRO); tezepelumabe (anti-TSLP) apresentou resultados positivos e publicados em 2025, incluindo redução de NPS, congestão e uso de corticoide sistêmico/cirurgia. Conclusão: Biológicos são eficazes e seguros em RSCPN com inflamação tipo 2 não controlada por terapia padrão, com seleção baseada em fenótipo/endótipo, comorbidades (asma/NSAID-ERD) e critérios de resposta de consensos atuais.
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Referências
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