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Seguridad y efectividad del uso de doxiciclina, corticosteroides y biológicos en pacientes con rinosinusitis crónica con poliposis nasal: revisión sistemática

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dc.contributor.advisorTrillos Peña, Carlos Enrique
dc.contributor.advisorMurillo Moreno, Diosa Jannelly
dc.creatorPeña Ruiz, Esteban
dc.creatorGarcía Cuevas, Jenny Catherin
dc.creator.degreeEspecialista en Epidemiología (en Convenio con el CES)
dc.creator.degreeLevelEspecialización
dc.date.accessioned2024-12-06T20:10:29Z
dc.date.available2024-12-06T20:10:29Z
dc.date.created2024-12-02
dc.date.embargoEndinfo:eu-repo/date/embargoEnd/2027-07-22
dc.descriptionEl documento aborda una revisión sistemática sobre la seguridad y efectividad de tratamientos farmacológicos para la rinosinusitis crónica con poliposis nasal (RSCcPN). Se evalúan tres tipos de tratamientos: biológicos (como dupilumab, mepolizumab, omalizumab y benralizumab), corticosteroides y doxiciclina, comparando su impacto en la remisión de síntomas y en la mejora de la calidad de vida de los pacientes. Los hallazgos muestran que los biológicos, especialmente dupilumab, tienen una eficacia destacada en la reducción de síntomas y la mejora de la calidad de vida. Los corticosteroides siguen siendo efectivos, pero su impacto disminuye en casos más severos. La doxiciclina presenta resultados mixtos, con mejoras en la calidad de vida, pero sin diferencias significativas en los desenlaces primarios. Además, se mencionan nuevas tecnologías como el sistema de administración por exhalación con fluticasona (EDS-FLU), que mostró mejoras significativas en los pacientes. Se concluye que los biológicos son una opción terapéutica prometedora para pacientes con inflamación tipo 2 severa y que se requieren más estudios comparativos y económicos para optimizar el tratamiento de esta patología.
dc.description.abstractIntroduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory condition that affects patients' quality of life, causing symptoms like nasal obstruction, anosmia, and infections. Treatment options include doxycycline, corticosteroids, and biologics (omalizumab, mepolizumab, dupilumab, and benralizumab), but the comparative safety and efficacy of these therapies remain unclear. This study investigates the safety and efficacy of these treatments for adults with CRSwNP. Objectives: The study evaluates the safety and effectiveness of doxycycline, corticosteroids, and biologics in treating CRSwNP, focusing on symptom remission and quality of life improvements. Methods: A systematic review of randomized controlled trials (RCTs) published between 2019 and 2024. Searches were conducted in PubMed, Ovid-MEDLINE, Scopus, and Cochrane, using MeSH strategies to identify studies on adults with CRSwNP treated with doxycycline, corticosteroids, and biologics. Data extraction was assisted by artificial intelligence tools, with discrepancies resolved by an expert reviewer. Results: Biologics, particularly Dupilumab, showed the most consistent efficacy, improving symptoms, preventing polyp recurrence, and enhancing quality of life. Mepolizumab and benralizumab had varying impacts on polyp size, congestion, and quality of life, while omalizumab was effective for congestion and quality of life. Doxycycline showed mixed results, and corticosteroids improved eosinophilic CRSwNP but had limited impact on symptom remission and quality of life. Discussion: Dupilumab demonstrated the best overall outcomes, suggesting it may be the leading treatment for severe CRSwNP. Further comparative studies on biologics are needed to refine treatment strategies and improve clinical outcomes. These findings offer insights to optimize CRSwNP management and reduce the economic burden of the condition.
dc.format.extent104 pp
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_44473
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/44473
dc.language.isospa
dc.publisherUniversidad del Rosario
dc.publisherUniversidad CES. Facultad de Medicina
dc.publisher.departmentEscuela de Medicina y Ciencias de la Salud
dc.publisher.programEspecialización en Epidemiología
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 International*
dc.rights.accesRightsinfo:eu-repo/semantics/embargoedAccess
dc.rights.accesoRestringido (Temporalmente bloqueado)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/*
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dc.source.instnameinstname:Universidad del Rosario
dc.source.reponamereponame:Repositorio Institucional EdocUR
dc.subjectSeguridad
dc.subjectEfectividad
dc.subjectUso de medicamentos
dc.subjectDoxiciclina
dc.subjectCorticoesteroides
dc.subjectRinosinusitis
dc.subjectPólipos nasales
dc.subjectTratamiento biológico
dc.subjectRinosinusitis crónica con poliposis nasal
dc.subjectCalidad de vida
dc.subjectCongestión nasal
dc.subjectRevisión sistemática
dc.subject.keywordSafety
dc.subject.keywordEffectiveness
dc.subject.keywordDrug Utilization
dc.subject.keywordDoxycycline
dc.subject.keywordAdrenal Cortex Hormones
dc.subject.keywordChronic Rhinosinusitis with Nasal Polyps
dc.subject.keywordDupilumab
dc.subject.keywordNasal Polyp Score
dc.subject.keywordNasal Congestion
dc.subject.keywordBiologics
dc.subject.keywordQuality of Life
dc.subject.keywordSNOT-22
dc.subject.keywordBenralizumab
dc.subject.keywordMepolizumab
dc.subject.keywordOmalizumab
dc.subject.keywordReslizumab
dc.subject.keywordSystemic Corticosteroids
dc.subject.keywordOral Corticosteroids
dc.subject.keywordSystematic Literature Review
dc.titleSeguridad y efectividad del uso de doxiciclina, corticosteroides y biológicos en pacientes con rinosinusitis crónica con poliposis nasal: revisión sistemática
dc.title.TranslatedTitleSafety and effectiveness of doxycycline, corticosteroids, and biologics in patients with chronic rhinosinusitis with nasal polyposis: a systematic review
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local.regionesBogotá
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Especialización en Epidemiología