EUFOREA/EPOS2020 statement on the clinical considerations for chronic rhinosinusitis with nasal polyps care

Peter W Hellings^{1

2

3}, Isam Alobid^{4

5

6}, Wilma T Anselmo-Lima⁷, Manuel Bernal-Sprekelsen^{8

9}, Leif Bjermer¹⁰, Lisa Caulley^{11

12

13}, Adam Chaker¹⁴, Jannis Constantinidis¹⁵, Diego M Conti¹⁶, Eugenio De Corso¹⁷, Martin Desrosiers¹⁸, Zuzana Diamant^{10

19

20

21}, Philippe Gevaert³, Joseph K Han²², Enrico Heffler^{23

24}, Claire Hopkins²⁵, Basile N Landis²⁶, Olga Lourenco^{27

28}, Valerie Lund²⁹, Amber U Luong³⁰, Joaquim Mullol³¹, Anju Peters³², Carl Philpott^{33

34}, Sietze Reitsma³⁵, Dermot Ryan³⁶, Glenis Scadding³⁷, Brent Senior³⁸, Peter Valentin Tomazic³⁹, Elina Toskala⁴⁰, Thibaut Van Zele³, An-Sofie Viskens^{1

41}, Martin Wagenmann⁴², W J Fokkens³⁵

Affiliations

¹ Department of Microbiology and Immunology, Allergy and Clinical Immunology Research unit, KU Leuven, Leuven, Belgium.
² Clinical Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
³ Department of Otorhinolaryngology, Upper airways research laboratory, Ghent University, Ghent, Belgium.
⁴ Rhinology and Skull Base Unit, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
⁵ Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
⁶ Center of Biomedical Research in Respiratory Diseases (CIBERES), Barcelona, Spain.
⁷ Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Brazil.
⁸ Department of Otorhinolaryngology, University of Barcelona, Barcelona, Spain.
⁹ Department of Otorhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain.
¹⁰ Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden.
¹¹ Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada.
¹² Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹³ Institut for Klinisk Medicin, Aarhus University, Aarhus, Denmark.
¹⁴ Dept. of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
¹⁵ 1st Department of Otorhinolaryngology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁶ The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium.
¹⁷ Otolaryngology, Head and Neck Surgery, Rhinology, A. Gemelli University Hospital Foundation, IRCSS, Rome, Italy.
¹⁸ Department of ORL-HNS, Université de Montréal, Montreal, Canada.
¹⁹ Department of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium.
²⁰ Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic.
²¹ Department of Clinical Pharmacy & Pharmacology, University in Groningen, University Medical Center Groningen, Groningen, Netherlands.
²² Department of Otolaryngology & Head and Neck Surgery, Eastern Virginia Medical School, Virginia, USA.
²³ Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital, Rozzano, Italy.
²⁴ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
²⁵ Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, UK.
²⁶ Rhinology-Olfactology Unit, Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Geneva, Geneva, Switzerland.
²⁷ FCS-UBI, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
²⁸ CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
²⁹ Royal National Ear, Nose and Eastman Dental Hospital, London, UK.
³⁰ Otolaryngology-HNS, McGovern Medical School of the University of Texas Health Science Center, Houston, Texas, USA.
³¹ Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Spain.
³² Division of Allergy and Immunology and Northwestern Sinus Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
³³ Rhinology & ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK.
³⁴ Norfolk & Waveney ENT Service, James Paget and Norfolk & Norwich University Hospitals, Norfolk, UK.
³⁵ Department of Otorhinolaryngology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.
³⁶ Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
³⁷ Royal National ENT Hospital, London and Division of Immunity and Infection, University College, London, UK.
³⁸ Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
³⁹ Department of General Otorhinolaryngology, H&N Surgery, Medical University of Graz, Graz, Austria.
⁴⁰ Otolaryngology-HNS, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
⁴¹ Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
⁴² Department of Otorhinolaryngology, Universitätsklinikum Düsseldorf, Dusseldorf, Germany.

PMID: 38108602
DOI: 10.1111/all.15982

Review

EUFOREA/EPOS2020 statement on the clinical considerations for chronic rhinosinusitis with nasal polyps care

Peter W Hellings et al. Allergy. 2024 May.

. 2024 May;79(5):1123-1133.

doi: 10.1111/all.15982. Epub 2023 Dec 18.

Authors

Affiliations

¹ Department of Microbiology and Immunology, Allergy and Clinical Immunology Research unit, KU Leuven, Leuven, Belgium.
² Clinical Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
³ Department of Otorhinolaryngology, Upper airways research laboratory, Ghent University, Ghent, Belgium.
⁴ Rhinology and Skull Base Unit, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
⁵ Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
⁶ Center of Biomedical Research in Respiratory Diseases (CIBERES), Barcelona, Spain.
⁷ Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Brazil.
⁸ Department of Otorhinolaryngology, University of Barcelona, Barcelona, Spain.
⁹ Department of Otorhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain.
¹⁰ Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden.
¹¹ Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada.
¹² Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹³ Institut for Klinisk Medicin, Aarhus University, Aarhus, Denmark.
¹⁴ Dept. of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
¹⁵ 1st Department of Otorhinolaryngology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁶ The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium.
¹⁷ Otolaryngology, Head and Neck Surgery, Rhinology, A. Gemelli University Hospital Foundation, IRCSS, Rome, Italy.
¹⁸ Department of ORL-HNS, Université de Montréal, Montreal, Canada.
¹⁹ Department of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium.
²⁰ Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic.
²¹ Department of Clinical Pharmacy & Pharmacology, University in Groningen, University Medical Center Groningen, Groningen, Netherlands.
²² Department of Otolaryngology & Head and Neck Surgery, Eastern Virginia Medical School, Virginia, USA.
²³ Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital, Rozzano, Italy.
²⁴ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
²⁵ Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, UK.
²⁶ Rhinology-Olfactology Unit, Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Geneva, Geneva, Switzerland.
²⁷ FCS-UBI, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
²⁸ CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
²⁹ Royal National Ear, Nose and Eastman Dental Hospital, London, UK.
³⁰ Otolaryngology-HNS, McGovern Medical School of the University of Texas Health Science Center, Houston, Texas, USA.
³¹ Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Spain.
³² Division of Allergy and Immunology and Northwestern Sinus Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
³³ Rhinology & ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK.
³⁴ Norfolk & Waveney ENT Service, James Paget and Norfolk & Norwich University Hospitals, Norfolk, UK.
³⁵ Department of Otorhinolaryngology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.
³⁶ Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
³⁷ Royal National ENT Hospital, London and Division of Immunity and Infection, University College, London, UK.
³⁸ Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
³⁹ Department of General Otorhinolaryngology, H&N Surgery, Medical University of Graz, Graz, Austria.
⁴⁰ Otolaryngology-HNS, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
⁴¹ Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
⁴² Department of Otorhinolaryngology, Universitätsklinikum Düsseldorf, Dusseldorf, Germany.

PMID: 38108602
DOI: 10.1111/all.15982

Abstract

Following the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) treatment algorithm for chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP), patients suffering from severe uncontrolled CRSwNP are recommended to receive oral corticosteroids, (revision) sinus surgery, systemic biologicals and/or aspirin treatment after desensitization (ATAD). Given the major differences in indications, outcomes, practical considerations, risks and costs of these key pillars of treatment, there is a growing need to define criteria for each treatment option and list the clinically relevant and major considerations for them. This EUFOREA document therefore provides an expert panel overview of the expected outcomes, specific considerations and (contra)indications of the five major treatment arms of severe uncontrolled CRSwNP: oral corticosteroids, primary and revision sinus surgery, biological treatment and ATAD. This overview of treatment considerations is needed to allow physicians and patients to consider the different options in the context of providing optimal and personalized care for severe uncontrolled CRSwNP. In conclusion, the five major treatment options for severe uncontrolled CRSwNP have intrinsic advantages, specific indications and considerations that are of importance to the patient, the physician and the society. This EUFOREA statement supports the unmet need to define criteria for the indication of every treatment pillar of CRSwNP.

Keywords: CRSwNP; aspirin intolerance; biologics; corticosteroids; sinus surgery.

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References

REFERENCES

1. Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Suppl S29):1‐464.
1. Hellings PW, Akdis CA, Bachert C, et al. EUFOREA Rhinology Research Forum 2016: report of the brainstorming sessions on needs and priorities in rhinitis and rhinosinusitis. Rhinology. 2017;55(3):202‐210.
1. Orlandi RR, Kingdom TT, Smith TL, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021;11(3):213‐739.
1. Katotomichelakis M, Tantilipikorn P, Holtappels G, et al. Inflammatory patterns in upper airway disease in the same geographical area may change over time. Am J Rhinol Allergy. 2013;27(5):354‐360.
1. Zhang Y, Gevaert E, Lou H, et al. Chronic rhinosinusitis in Asia. J Allergy Clin Immunol. 2017;140(5):1230‐1239.

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EUFOREA/EPOS2020 statement on the clinical considerations for chronic rhinosinusitis with nasal polyps care

Affiliations

EUFOREA/EPOS2020 statement on the clinical considerations for chronic rhinosinusitis with nasal polyps care

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources