La gestione del paziente con rinosinusite cronica e poliposi nasale in Italia: expert opinion sul percorso diagnostico-terapeutico
Francesco Menzella,
Diego Bagnasco,
Maria Beatrice Bilò,
Marco Caminati,
Carlo Cavaliere,
Marco Contoli,
Alessio De Massimi,
Stefania Gallo,
Andrea Matucci,
Giancarlo Ottaviano,
Oliviero Rossi,
Veronica Seccia,
Martino Emmi,
Frank Rikki Canevari
Affiliations
Francesco Menzella
UOC Pneumologia Distretto di Asolo – AULSS2 Marca Trevigiana, Treviso - Italy
Diego Bagnasco
Centro Asma Grave, IRCCS Policlinico San Martino, Genova - Italy
Maria Beatrice Bilò
Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona - Italy and Allergologia, Azienda Ospedaliero-Universitaria delle Marche, Ancona - Italy
Marco Caminati
Allergologia Asma e Immunologia Clinica – Dipartimento di Medicina Università di Verona, Verona - Italy
Carlo Cavaliere
Dipartimento di Organi di Senso, Sapienza Università di Roma, Roma - Italy
Marco Contoli
Malattie Apparato Respiratorio – Dipartimento di Medicina Traslazionale Università di Ferrara, Ferrara - Italy
Alessio De Massimi
UOS di Otorinolaringoiatria, Servizio di Rinologia e Chirurgia endoscopica naso-sinusale – Azienda Sanitaria Friuli Occidentale, Ospedale San Vito al Tagliamento, San Vito al Tagliamento, Pordenone - Italy
Stefania Gallo
Clinica Otorinolaringoiatrica, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese - Italy and UPLOAD Research Center, Università degli Studi dell’Insubria, Varese - Italy
Andrea Matucci
Allergologia – Ospedale Careggi di Firenze, Firenze - Italy
Giancarlo Ottaviano
Otorinolaringoiatria – Ospedale Università di Padova, Padova - Italy
Oliviero Rossi
Allergologia – Ospedale Careggi di Firenze, Firenze - Italy
Chronic rhinosinusitis (CRS) is an inflammatory disease that affects the nasal mucosa and the paranasal sinuses; it can be characterized by nasal polyposis (CRSwNP) in up to 30% of cases. CRSwNP is frequently associated with bronchial asthma 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 increase of eosinophils, IgE, interleukin (IL)-4, IL-5 and IL-13. Biological drugs that target inflammatory molecules are currently a 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 intervention are 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 a series of virtual expert meetings the main criteria for patient characterization and therapeutic decision, highlighting multidisciplinarity, the constant dialogue between doctor and patient, the organization in networks and the use of registries as strategies to implement the management of CRSwNP patients, to reach the personalization of the treatment and the best use of the biological drug(s).
