Management of patients with chronic rhinosinusitis and nasal polyposis in Italy: expert opinion on the diagnostic-therapeutic approach

Authors

  • Francesco Menzella UOC Pneumologia Distretto di Asolo – AULSS2 Marca Trevigiana, Treviso - Italy https://orcid.org/0000-0003-3950-5789
  • Diego Bagnasco Centro Asma Grave, IRCCS Policlinico San Martino, Genova - Italy https://orcid.org/0000-0002-3661-5731
  • Maria Beatrice Bilò Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona - Italy and Allergologia, Azienda Ospedaliero-Universitaria delle Marche, Ancona - Italy
  • Marco Caminati Allergologia Asma e Immunologia Clinica – Dipartimento di Medicina Università di Verona, Verona - Italy
  • Carlo Cavaliere Dipartimento di Organi di Senso, Sapienza Università di Roma, Roma - Italy https://orcid.org/0000-0002-0378-8935
  • Marco Contoli Malattie Apparato Respiratorio – Dipartimento di Medicina Traslazionale Università di Ferrara, Ferrara - Italy
  • Alessio De Massimi UOS di Otorinolaringoiatria, Servizio di Rinologia e Chirurgia endoscopica naso-sinusale – Azienda Sanitaria Friuli Occidentale, Ospedale San Vito al Tagliamento, San Vito al Tagliamento, Pordenone - Italy https://orcid.org/0000-0002-7244-4423
  • Stefania Gallo Clinica Otorinolaringoiatrica, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese - Italy and UPLOAD Research Center, Università degli Studi dell’Insubria, Varese - Italy
  • Andrea Matucci Allergologia – Ospedale Careggi di Firenze, Firenze - Italy
  • Giancarlo Ottaviano Otorinolaringoiatria – Ospedale Università di Padova, Padova - Italy https://orcid.org/0000-0003-2433-4761
  • Oliviero Rossi Allergologia – Ospedale Careggi di Firenze, Firenze - Italy
  • Veronica Seccia UO Otorinolaringoiatria Audiologia Foniatria Universitaria – Azienda Ospedaliero-Universitaria Pisana, Pisa - Italy https://orcid.org/0000-0002-6297-8034
  • Martino Emmi Novartis Farma, Milan - Italy https://orcid.org/0009-0009-3487-2732
  • Frank Rikki Canevari IRCCS Ospedale Policlinico San Martino, Genova - Italy and IRCCS Ospedale Policlinico San Martino, Genova - Italy https://orcid.org/0000-0002-1821-7262

DOI:

https://doi.org/10.33393/ao.2023.2555

Keywords:

Biological drugs, Chronic rhinosinusitis with nasal polyps, CRSwNP, Nasal polyposis, QoL, Quality of life, Systemic steroids

Abstract

Chronic rhinosinusitis (CRS) is an inflammatory disease that affects the nasal mucosa and the paranasal sinuses; it can be characterized by nasal polyposis (CRSwNP) in up to 30% of cases. CRSwNP is frequently associated with bronchial asthma and patients affected show a greater severity of clinical disease with a significantly worse quality of life.

CRSwNP shows predominantly an underlying activation of type 2 inflammatory pathways with the increase of eosinophils, IgE, interleukin (IL)-4, IL-5 and IL-13. Biological drugs that target inflammatory molecules are currently a therapeutic option recognized by guidelines for the treatment of uncontrolled form of the disease.

The correct definition of the target patient, the type of biological drug to be used and the timing of intervention are crucial to guarantee a personalized therapy and optimize the cost/effectiveness of the treatment.

A panel of Italian pneumologists, allergologists, immunologists and ear, nose and throat specialists discussed in a series of virtual expert meetings the main criteria for patient characterization and therapeutic decision, highlighting multidisciplinarity, the constant dialogue between doctor and patient, the organization in networks and the use of registries as strategies to implement the management of CRSwNP patients, to reach the personalization of the treatment and the best use of the biological drug(s).

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Published

2023-03-13

How to Cite

1.
Menzella F, Bagnasco D, Bilò MB, Caminati M, Cavaliere C, Contoli M, De Massimi A, Gallo S, Matucci A, Ottaviano G, Rossi O, Seccia V, Emmi M, Canevari FR. Management of patients with chronic rhinosinusitis and nasal polyposis in Italy: expert opinion on the diagnostic-therapeutic approach. abtpn [Internet]. 2023 Mar. 13 [cited 2023 Apr. 1];10(1):43-9. Available from: https://journals.aboutscience.eu/index.php/aboutopen/article/view/2555
Received 2022-12-16
Accepted 2023-02-20
Published 2023-03-13