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. 2025 May 29:6:1594655.
doi: 10.3389/falgy.2025.1594655. eCollection 2025.

Fluticasone propionate in chronic rhinosinusitis with nasal polyps (CRSwNP): an artificial intelligence-driven consensus

Emilio Avallone  1 , Raffaella Iannella  1 , Antonella Di Lullo  1 , Michele Grasso  1 , Salvatore Musto  1 , Enzo Piermichele Troncone  2 , Giuseppe Tortoriello  3 , Bernardino Cassiano  4 , Simona Nappi  4 , Gianluca Bava  5 , Giovanna Piazzetta  6 , Giovanni Tomacelli  7 , Aurelio D'Ecclesia  8 , Giacomo Spinato  9 , Giacomo Matrone  10 , Doriano Politi  11 , Carlo De Luca  12 , Claudio Caporale  13 , Livio Presutti  14   15 , Gabriele Molteni  14   15 , Ernesto Pasquini  16 , Francesco Panu  17 , Simonetta Masieri  18 , Stefano Di Girolamo  19 , Giulio Cesare Passali  20 , Luca de Campora  21 , Giandomenico Maggiore  22 , Domenico Di Maria  1
Affiliations

Fluticasone propionate in chronic rhinosinusitis with nasal polyps (CRSwNP): an artificial intelligence-driven consensus

Emilio Avallone et al. Front Allergy. .

Abstract

Introduction: Fluticasone propionate (FP) is a topical corticosteroid used to treat rhinosinusitis with nasal polyposis (CRSwNP). However, the need for a consensus on its use stems from the increasing focus on optimizing topical therapies to improve clinical outcomes and minimize systemic side effects.

Materials and methods: The Butterfly Decisions AI platform facilitated the collection and integration of evaluations and feedback, facilitating an expert consensus on 13 statements.

Results: The participants agreed highly on the different statements. The experts agreed that FP effectively reduces the need for surgery and controls the symptoms of CRSwNP. The use of advanced delivery systems significantly improved drug delivery and therapeutic outcomes. Treatment with FP was associated with a reduction in the recurrence of nasal polyps and an improvement in the patient's quality of life.

Conclusions: FP, as other equal corticosteroids, represents a first-line local therapy for patients with CRSwNP without complicating comorbidities due to its high efficacy and low systemic bioavailability. The Butterfly Decisions platform has demonstrated the effectiveness of integrating AI tools into clinical decision-making, improving the transparency and objectivity of assessments.

Keywords: CRSwNP; butterfly; consensus; fluticasone; nasal drops.

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Conflict of interest statement

EPT and GMat are employed by Butterfly Decisions S.r.l. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
General screen of butterfly software.
Figure 2
Figure 2
Workflow of the decision-making process used by the butterfly software.
Figure 3
Figure 3
A screenshot of the text that the expert must evaluate, including options to agree, disagree, provide comments, and the certainty index.
Figure 4
Figure 4
Dashboard of the statements.
See this image and copyright information in PMC

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