Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 May 23;12(5):846.
doi: 10.3390/jpm12050846.

Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement

Eugenio De Corso  1 , Maria Beatrice Bilò  2   3 , Andrea Matucci  4 , Veronica Seccia  5 , Fulvio Braido  6   7 , Matteo Gelardi  8 , Enrico Heffler  9   10 , Manuela Latorre  11 , Luca Malvezzi  10   12 , Girolamo Pelaia  13 , Gianenrico Senna  14 , Paolo Castelnuovo  15   16   17 , Giorgio Walter Canonica  9   10
Affiliations
Review

Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement

Eugenio De Corso et al. J Pers Med. .

Abstract

Chronic rhinosinusitis (CRS) is a sino-nasal chronic inflammatory disease, occurring in 5-15% of the general population. CRS with nasal polyps (CRSwNP) is present in up to 30% of the CRS population. One-third of CRSwNP patients suffer from disease that is uncontrolled by current standards of care. Biologics are an emerging treatment option for patients with severe uncontrolled CRSwNP, but their positioning in the treatment algorithm is under discussion. Effective endotyping of CRSwNP patients who could benefit from biologics treatment is required, as suggested by international guidelines. Other issues affecting management include comorbidities, such as allergy, non-steroidal anti-inflammatory drug-exacerbated respiratory disease, and asthma. Therefore, the choice of treatment in CRSwNP patients depends on many factors. A multidisciplinary approach may improve CRSwNP management in patients with comorbidities, but currently there is no shared management model. We summarize the outcomes of a Delphi process involving a multidisciplinary panel of otolaryngologists, pulmonologists, and allergist-immunologists involved in the management of CRSwNP, who attempted to reach consensus on key statements relating to the diagnosis, endotyping, classification and management (including the place of biologics) of CRSwNP patients.

Keywords: allergy; asthma; biologics; chronic rhinosinusitis; hypersensitivity; nasal polyps; non-steroidal anti-inflammatory drugs; type 2 inflammation.

PubMed Disclaimer

Conflict of interest statement

EDC has received advisory board fees or speaker fees from GlaxoSmithKline, Novartis, and Sanofi-Genzyme. MBB has received advisory board fees or speaker fees from ALK-Abelló, AstraZeneca, GlaxoSmithKline, Menarini, Novartis, and Sanofi. VS has received speaker fees or advisory board fees from AstraZeneca, GlaxoSmithKline, Sanofi, and Novartis. FB has received research grants or advisory board fees or speaker fees from Menarini, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Guidotti-Malesci, GlaxoSmithKline, Merck Sharp & Dohme, Mundipharma, Novartis, Sanofi, Stallergenes-Greer, and Alfasigma. MG has received advisory board fees or speaker fees from GlaxoSmithKline, Novartis, Sanofi-Genzyme, Valeas, DMG Italia, FIRMA, Aurora Biofarma, and Fenix Pharma. EH has received speaker activity and advisory board participation fees from Novartis, GlaxoSmithKline, Sanofi, Regeneron, AstraZeneca, Stallergenes-Greer, Circassia, and Nestlè Purina. ML has received speaker fees or advisory board fees from GlaxoSmithKline, AstraZeneca, Chiesi Farmaceutici, Guidotti-Malesci, Sanofi, Menarini, and Alfasigma. GP has received lecture fees and advisory board fees from ABC, Alfasigma, AstraZeneca, GlaxoSmithKline, Guidotti-Malesci, Menarini, Novartis, Sanofi, and Zambon. GS has received advisory board fees or speaker fees from AstraZeneca, GlaxoSmithKline, Menarini, Novartis, and Sanofi. PC has, in the last two years, had received grants or fees from Karl Storz, Medtronic, Novartis, GlaxoSmithKline, and Sanofi-Aventis. GWC has received research grants, advisory board fees or speaker fees from Menarini, ALK-Abelló, Allergy Therapeutics, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Genentech, Guidotti-Malesci, GlaxoSmithKline, Hal Allergy, Mylan, Merck Sharp & Dohme, Mundipharma, Novartis, Regeneron, Sanofi-Aventis, Sanofi-Genzyme, Stallergenes-Greer, UCB Pharma, Valeas, and Vibor-Pharma. AM and LM have no relevant financial interests to disclose.

Figures

Figure 1
Figure 1
Flow diagram of the Delphi process leading to consensus.
Figure 2
Figure 2
Topics identified as relevant by the scientific board.
See this image and copyright information in PMC

References

    1. Fokkens W.J., Lund V.J., Hopkins C., Hellings P.W., Kern R., Reitsma S., Toppila-Salmi S., Bernal-Sprekelsen M., Mullol J., Alobid I., et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58:1–464. doi: 10.4193/Rhin20.401. - DOI - PubMed
    1. Bachert C., Marple B., Schlosser R.J., Hopkins C., Schleimer R.P., Lambrecht B.N., Broker B.M., Laidlaw T., Song W.J. Adult chronic rhinosinusitis. Nat. Rev. Dis. Primers. 2020;6:86. doi: 10.1038/s41572-020-00218-1. - DOI - PubMed
    1. Hastan D., Fokkens W.J., Bachert C., Newson R.B., Bislimovska J., Bockelbrink A., Bousquet P.J., Brozek G., Bruno A., Dahlen S.E., et al. Chronic rhinosinusitis in Europe--an underestimated disease. A GA(2)LEN study. Allergy. 2011;66:1216–1223. doi: 10.1111/j.1398-9995.2011.02646.x. - DOI - PubMed
    1. Palmer J.N., Messina J.C., Biletch R., Grosel K., Mahmoud R.A. A cross-sectional, population-based survey of U.S. adults with symptoms of chronic rhinosinusitis. Allergy Asthma Proc. 2019;40:48–56. doi: 10.2500/aap.2019.40.4182. - DOI - PubMed
    1. Dietz de Loos D., Lourijsen E.S., Wildeman M.A.M., Freling N.J.M., Wolvers M.D.J., Reitsma S., Fokkens W.J. Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology. J. Allergy Clin. Immunol. 2019;143:1207–1214. doi: 10.1016/j.jaci.2018.12.986. - DOI - PubMed

LinkOut - more resources