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Related Concept Videos

Drugs Used in Upper Respiratory Disorders: Overview01:16

Drugs Used in Upper Respiratory Disorders: Overview

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Upper respiratory tract disorders, including viral infections and allergic rhinitis, cause significant discomfort and disrupt daily life. Managing these conditions involves a variety of drugs, such as antihistamines, intranasal steroids, decongestants, antitussives, expectorants, and mucolytics. Specific examples of drugs in each category are provided.
Antihistamines (e.g., Benadryl) block histamines from binding. Histamines are chemicals released during an allergic reaction in the body. As a...
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Drugs Used in Lower Respiratory Disorders: Overview01:17

Drugs Used in Lower Respiratory Disorders: Overview

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Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Drug Products: Biologics, Biosimilars and Interchangeables01:28

Drug Products: Biologics, Biosimilars and Interchangeables

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Body:Biologics, derived from living sources such as humans, animals, or microorganisms, represent a significant category of pharmaceuticals. These complex molecules, developed through advanced biotechnological methods or purified from natural sources, include essential medical treatments like insulin and growth hormones. The complexity of biologics arises from their large molecular structures and the intricate processes required for their production, making them distinct from conventional...
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Drug Delivery: Miscellaneous Routes01:22

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Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection,  and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
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Biologics for chronic rhinosinusitis.

Lee-Yee Chong1, Patorn Piromchai2, Steve Sharp3

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Biologics like dupilumab, mepolizumab, and omalizumab show promise in treating chronic rhinosinusitis with nasal polyps. Dupilumab significantly improved quality of life and disease severity, with potential reductions in adverse events.

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Area of Science:

  • Otolaryngology
  • Immunology
  • Pharmacology

Background:

  • Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition affecting nasal and sinus linings, characterized by symptoms like nasal blockage and loss of smell.
  • Biologics, particularly monoclonal antibodies, are emerging treatments for inflammatory conditions and are being evaluated for CRS management.
  • This living systematic review focuses on the efficacy and safety of biologics in patients with chronic rhinosinusitis.

Purpose of the Study:

  • To assess the therapeutic effects of biologic agents in patients diagnosed with chronic rhinosinusitis.
  • To evaluate the impact of biologics on disease-specific quality of life, symptom severity, and adverse events.

Main Methods:

  • A systematic review of randomized controlled trials (RCTs) comparing biologics (monoclonal antibodies) against placebo in CRS patients.
  • Included studies required a minimum follow-up of three months.
  • Primary outcomes included health-related quality of life (HRQL), disease severity, and serious adverse events (SAEs); secondary outcomes covered surgery avoidance, disease extent, and general HRQL.

Main Results:

  • Dupilumab demonstrated significant improvements in disease-specific HRQL (SNOT-22 scores) and likely reduced disease severity.
  • Mepolizumab showed potential improvements in disease-specific HRQL, though evidence for disease severity and SAEs was uncertain.
  • Omalizumab also likely improved disease-specific HRQL, but evidence regarding disease severity and SAEs was very uncertain.

Conclusions:

  • In patients with chronic rhinosinusitis, particularly those with nasal polyps and concurrent asthma, dupilumab effectively improves quality of life and disease severity.
  • Mepolizumab and omalizumab may offer benefits for disease-specific HRQL, but further research is needed to confirm their effects on overall disease severity and safety.
  • Biologics represent a promising therapeutic avenue for severe chronic rhinosinusitis, warranting continued investigation and clinical application.