Chronic rhinosinusitis with nasal polyposis and biological agents: the ARIA-ITALY Survey

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Authors Information

1Co-Chairman ARIA ITALY; Unit of Allergology, Clinical Immunology & Respiratory Diseases, Fondazione Poliambulanza, Brescia, Italy
2Co-Chairman ARIA-Italy Allergy and Respiratory Diseases, IRCCS Policlinico S. Martino, University of Genoa, Genoa, Italy
3UOC Pulmonary, "S. Valentino" Hospital, AULSS 2 Marca Trevigiana, Montebelluna, Treviso, Italy
4Department of DISC, Otolaryngologist Clinic-IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
5Unità Operativa di Otorinolaringoiatria e Microchirurgia della Base Cranica Papa Giovanni XXIII Hospital, Bergamo, Italy
6Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Telese Terme, Benevento, Italy
7UOC Respiratory System Diseases, Università degli Studi di Catania, Catania, Italy
8UOC Respiratory System Diseases, Papa Giovanni XXIII Hospital, Bergamo, Italy
9UOC Pulmonary, Azienda Ospedaliera Universitaria Verona, Verona, Italy
10Unit of Allergology, Casa di Cura B. Palazzolo, Bergamo, Italy
11Società Italiana di Asma Allergologia e Immunologia Clinica, University of Chieti, Chieti, Italy
12 Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Italy
13Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy
14ENT Clinic, University of Foggia, Foggia, Italy
15Asthma Center and Allergy Unit, University of Verona and General Hospital, Verona, Italy
16Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital, Rozzano, Milan, Italy


Published: 27 March 2024
Accepted: 26 March 2024
Received: 30 January 202

*Stefania Arasi, Diego Bagnasco, Ilaria Baiardini, Simona Barbaglia, Fabiola Barosso, Roberto Bernardini, Alvise Berti, Beatrice Bilò, Luisa Brussino, Frank Rikki Canevari, Giorgio Walter Canonica, Cristiano Caruso, Antonio Caviglia, Lorenzo Cecchi, Pasquale Comberiati, Lorenzo Cosmi, Marcello Cottini, Mariangiola Crivellaro, Danilo Di Bona, Alessando Fiocchi, Sandra Frateiacci, Matteo Gelardi, Giuseppe Guida, Enrico Heffler, Cristoforo Incorvaia, Massimo Landi, Amelia Licari, Luca Malvezzi, Manlio Milanese, Eustachio Nettis, Gianni Pala, Vincenzo Patella, Diego Peroni, Silvia Peveri, Francesca Puggioni, Alessandro Maria Pusateri, Erminia Ridolo, Oliviero Rossi, Eleonora Savi, Jan Schroeder, Veronica Seccia, Gianenrico Senna, Massimo Triggiani, Marzio Uberti, Gilda Varricchi, Maria Teresa Ventura, Maria Teresa Zedda. 


Background. Chronic rhinosinusitis (CRS) is an inflammatory disease that affects the nasal mucosa and the paranasal sinuses. CRS can be associated by nasal polyposis (CRSwNP phenotype) in up to 30% of patients and it is frequently associated with bronchial asthma.  CRSwNP shows predominantly an underlying activation of type 2 inflammatory pathways with the involvement of eosinophils, IgE, interleukin (IL)-4, IL-5 and IL-13. Biological drugs that target these inflammatory cytokines are currently a therapeutic option recognized by guidelines for the treatment of uncontrolled form of the disease. Methods. As part of the activity of the “ARIA-Italy” working group, a panel of 255 Italian Ear, Nose and Throat (ENT) specialists, pneumologists and immuno-allergologists actively participated in this national survey and answered a series of questions geared toward understanding the main criteria for patient characterization and therapeutic decision, highlighting multidisciplinarity, and the implementation of the management of CRSwNP patients, as a part of the precision medicine concept and the appropriate use of the biologicals. Results. Two hundred and fifty-five experts and specialists participated in the survey. Conclusions. The results of this survey obtained from an extensive number of active specialists throughout Italy allow some important concluding remarks to be drawn. The main points of agreement were that multidisciplinary care teams provide many benefits but that, once the team is established, meetings and communication between members must be coordinated. Finally, the dissemination of national disease registries and the continuous updating of guidelines and position papers related to CRSwNP and comorbidities should be encouraged.

Chronic RhinoSinusitis with nasal polyposis phenotype; CRSwNP; bronchial asthma; multidisciplinarity; biological agents.

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