General recommendations on the provision of biologics in an ENT
setting
Biologics should be available only in a designated specialist centres
that can offer appropriate alternative interventions
Specialist centres should be co-located with Severe Asthma clinics that
are already providing biologic therapies.
A CT scan is required to establish extent of disease and that of
previous surgery
Endoscopic confirmation is essential in the assessment of eligibility
and response
Revision surgery should be considered prior to a biologic if the
previous surgery was a polypectomy without opening the sinuses
Until there is evidence to support the safety and efficacy of biologics
in CRS without nasal polyps, biologics should NOT be prescribed
Outside of the NHS, self-paying patients with CRSwNP may select biologic
therapies as an alternative to surgery or OCS provided that they have
been given information regarding the risks and benefits of each option