Management of patients with chronic rhinosinusitis and nasal polyposis in Italy: expert opinion on the diagnostic-therapeutic approach
Keywords:Biological drugs, Chronic rhinosinusitis with nasal polyps, CRSwNP, Nasal polyposis, QoL, Quality of life, Systemic steroids
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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Copyright (c) 2023 Francesco Menzella, Diego Bagnasco, Maria Beatrice Bilò, Marco Caminati, Carlo Cavaliere, Marco Contoli, Alessio De Massimi, Stefania Gallo, Andrea Matucci, Giancarlo Ottaviano, Oliviero Rossi, Veronica Seccia, Martino Emmi, Frank Rikki Canevari
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