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. 2021 Nov 1;14(10):100592.
doi: 10.1016/j.waojou.2021.100592. eCollection 2021 Oct.

ARIA-ITALY multidisciplinary consensus on nasal polyposis and biological treatments

Carlo Lombardi  1 , Riccardo Asero  2 , Diego Bagnasco  3 , Francesco Blasi  4 , Matteo Bonini  5 , Mario Bussi  6 , Rikki F Canevari  7 , Giorgio Walter Canonica  8 , Paolo Castelnuovo  9 , Lorenzo Cecchi  10 , Lorenzo Cosmi  11 , Matteo Gelardi  12 , Enrico Heffler  8 , Luciana Indinnimeo  13 , Massimo Landi  14 , Amelia Licari  15 , Francesco Liotta  11 , Alberto Macchi  16 , Luca Malvezzi  17 , Gianluigi Marseglia  15 , Claudio Micheletto  18 , Antonino Musarra  19 , Diego Peroni  20 , Giorgio Piacentini  21 , Venerino Poletti  22 , Luca Richeldi  23 , Angela Santoni  24 , Michele Schiappoli  25 , Gianenrico Senna  25 , Adriano Vaghi  26 , Alberto Villani  27 , Giovanni Passalacqua  3 ; ARIA Italia
Affiliations

ARIA-ITALY multidisciplinary consensus on nasal polyposis and biological treatments

Carlo Lombardi et al. World Allergy Organ J. .

Abstract

In the recent years, it was recognized that type-2 inflammation links many forms of nasal polyposis with severe asthma. Thus, some biological drugs developed for severe asthma appeared to exert an effect on nasal polyposis. So far, there are several trials supporting this concept; therefore, some monoclonal antibodies for severe asthma were assessed also in polyposis, with promising results. Since different specialists are involved in the management of nasal polyposis (eg, pulmonologists, ENT, allergists), it was felt that an educational and informative document was needed to better identify the indications of biologicals in nasal polyposis. We collected the main Italian Scientific Societies, and prepared (under the Allergic Rhinitis and its Impact on Asthma, ARIA) a document endorsed by all Societies, to provide a provisional statement for the future use of monoclonal antibodies as a medical treatment for polyposis. It is the first nationwide endorsed document on this aspect. The current pathogenic knowledge and the experimental evidence are herein reviewed, and some suggestions for a correct prescription and follow-up are provided.

Keywords: ARIA; Biological antibodies; CRSwNP; Nasal polyps; Personalized medicine.

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Conflict of interest statement

There are no conflicts of interest reported for any of the authors.

Figures

Fig. 1
Fig. 1
Main mechanisms of type 2 inflammation (Modified from: Yao Y et al. Eur Arch Oto-Laringology 2017; 274: 3559)
Fig. 2
Fig. 2
A) Possible criteria for the use of biologic drugs in NP (from 41, modified); B) Assessment of the response to biologicals (from 41, modified)
See this image and copyright information in PMC

References

    1. Hopkins C. Chronic rhinosinusitis with nasal polyps. NEJM. 2019;381(1):55–63. - PubMed
    1. Fokkens W.J., Lund V.J., Mullol J. European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl. 2012;23:1–298. - PubMed
    1. Hulse K.E., Stevens W.W., Tan B.K., Schleimer R.P. Pathogenesis of nasal polyposis. Clin Exp Allergy. 2015;45:328–346. - PMC - PubMed
    1. Hastan D., Fokkens W.J., Bachert C. Chronic rhinosinusitis in Europe–an underestimated disease. A GA2LEN study. Allergy. 2011;66:1216–1223. - PubMed
    1. Hirsch A.G., Stewart W.F., Sundaresan A.S. Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy. 2017;72:274–281. - PMC - PubMed