Chronic rhinosinusitis (CRS) is an inflammatory disease that affects the nasal mucosa and the paranasal sinuses; itcan be characterized by nasal polyposis (CRSwNP) in up to 30% of cases. CRSwNP is frequently associated with bronchialasthma 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 increaseof eosinophils, IgE, interleukin (IL)-4, IL-5 and IL-13. Biological drugs that target inflammatory molecules are currentlya 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 interventionare 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 aseries of virtual expert meetings the main criteria for patient characterization and therapeutic decision, highlightingmultidisciplinarity, the constant dialogue between doctor and patient, the organization in networks and theuse of registries as strategies to implement the management of CRSwNP patients, to reach the personalization ofthe treatment and the best use of the biological drug(s).
Management of patients with chronic rhinosinusitis and nasal polyposis in Italy: expert opinion on the diagnostic-therapeutic approach (La gestione del paziente con rinosinusite cronica e poliposi nasale in Italia: expert opinion sul percorso diagnostico-terapeutico)
Carlo Cavaliere;
2023-01-01
Abstract
Chronic rhinosinusitis (CRS) is an inflammatory disease that affects the nasal mucosa and the paranasal sinuses; itcan be characterized by nasal polyposis (CRSwNP) in up to 30% of cases. CRSwNP is frequently associated with bronchialasthma 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 increaseof eosinophils, IgE, interleukin (IL)-4, IL-5 and IL-13. Biological drugs that target inflammatory molecules are currentlya 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 interventionare 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 aseries of virtual expert meetings the main criteria for patient characterization and therapeutic decision, highlightingmultidisciplinarity, the constant dialogue between doctor and patient, the organization in networks and theuse of registries as strategies to implement the management of CRSwNP patients, to reach the personalization ofthe treatment and the best use of the biological drug(s).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
