World Allergy Organization Journal (May 2025)
ARIA-Italy multidisciplinary consensus on nasal polyposis and biological treatments: Update 2025
- Carlo Lombardi, MD,
- Rikki F. Canevari, MD,
- Diego Bagnasco, MD,
- Maria Beatrice Bilò, MD,
- Giorgio Walter Canonica, MD,
- Cristiano Caruso, MD,
- Paolo Castelnuovo, MD,
- Lorenzo Cecchi, MD,
- Orietta Calcinoni, MD,
- Mauro Carone, MD,
- Marco Cassatella, MD,
- Renato Cutrera, MD,
- Gianni Danesi, MD,
- Eugenio De Corso, MD,
- Mario Di Gioacchino, MD,
- Fabiano Di Marco, MD,
- Stefania Gallo, MD,
- Matteo Gelardi, MD,
- Enrico Heffler, MD,
- Clara Imperatore, MD,
- Cristiana Indolfi, MD,
- Massimo Landi, MD,
- Amelia Licari, MD,
- Francesco Liotta, MD,
- Alberto Macchi, MD,
- Luca Malvezzi, MD,
- Sara Manti, MD,
- Francesco Menzella, MD,
- Claudio Micheletto, MD,
- Fabio Midulla, MD,
- Michele Miraglia Del Giudice, MD,
- Antonino Musarra, MD,
- Vincenzo Patella, MD,
- Diego Peroni, MD,
- Laura Petrarca, MD,
- Giorgio Piacentini, MD,
- Alessandro Pusateri, MD,
- Veronica Seccia, MD, PhD,
- Gianenrico Senna, MD,
- Adriano Vaghi, MD,
- Carlo Vancheri, PhD,
- Giovanni Passalacqua, MD,
- S. Arasi,
- D. Bagnasco,
- I. Baiardini,
- S. Barbaglia,
- F. Barosso,
- R. Bernardini,
- A. Berti,
- B. Bilò,
- L. Brussino,
- F.R. Canevari,
- G.W. Canonica,
- C. Caruso,
- A.A. Caruso,
- A.G. Caviglia,
- L. Cecchi,
- P. Comberiati,
- L. Cosmi,
- M. Cottini,
- M. Crivellaro,
- D. Di Bona,
- A. Fiocchi,
- S. Frateiacci,
- M. Gelardi,
- G. Guida,
- E. Heffler,
- C. Incorvaia,
- M. Landi,
- M.A. Licari,
- L. Malvezzi,
- M. Milanese,
- F. Mina,
- E. Nettis,
- G. Pala,
- V. Patella,
- D. Peroni,
- S. Peveri,
- F. Puggioni,
- A. Pusateri,
- O. Rossi,
- E. Ridolo,
- E. Savi,
- J. Schroeder,
- V. Seccia,
- G.E. Senna,
- M. Triggiani,
- M. Uberti,
- G. Varricchi,
- M.T. Ventura,
- M.T. Zedda
Affiliations
- Carlo Lombardi, MD
- Unit of Allergology, Clinical Immunology & Respiratory Diseases, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy; Corresponding author. Unit of Allergology, Clinical Immunology & Respiratory Diseases, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
- Rikki F. Canevari, MD
- Dipartimento DISC, Clinica Otorinolaringoiatria, IRCCS Policlinico San Martino, Università di Genova, Italy
- Diego Bagnasco, MD
- Allergy and Respiratory Diseases, IRCCS PoliclinicoS.Martino, University of Genoa, Italy
- Maria Beatrice Bilò, MD
- Dipartimento di Scienze Cliniche e Molecolari (DISCLIMO), Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
- Giorgio Walter Canonica, MD
- Department of Biomedical Science-Humanitas University-Pieve Emanuele (MI), Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital-Rozzano (NI), Italy
- Cristiano Caruso, MD
- UOSD DH Internal Medicine and Digestive Diseases, Fondazione Policlinico A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome Italy
- Paolo Castelnuovo, MD
- DBSV, Clinica ORL, Università Insubria, ASST-Settelaghi, Varese, Italy
- Lorenzo Cecchi, MD
- SOS Allergologia e Immunologia Clinica Prato, USL Toscana Centro, Italy
- Orietta Calcinoni, MD
- Società Italiana Liberi Professionisti, Centro Medico Turati, Milan, Italy
- Mauro Carone, MD
- Istituti Clinici Scientifici Maugeri, IRCCS Bari, UOC di Pneumologia, Bari, Italy
- Marco Cassatella, MD
- Società Italiana di Immunologia Clinica e Allergologia.PatologIa Generale, University of Italy, Italy
- Renato Cutrera, MD
- Pediatric Pulmonology and Cystic Fibrosis Unit Respiratory Intermediate Care Unit, Sleep and Long Term Ventilation Unit, ERN - Lung Reference Center for Rare Respiratory diseases Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Gianni Danesi, MD
- UnitàOperativa di Otorinolaringoiatria e Microchirurgia della Base Cranica, Ospedale Papa Giovanni XXIII, Bergamo, Italy
- Eugenio De Corso, MD
- Otorhinolaryngology Unit, A. Gemelli University Hospital IRCCS, Rome, Italy
- Mario Di Gioacchino, MD
- Società Italiana di Asma Allergologia e Immunologia Clinica, University of Chieti, Italy
- Fabiano Di Marco, MD
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, ASST Papa Giovanni XXIII, Bergamo, Italy
- Stefania Gallo, MD
- Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Matteo Gelardi, MD
- ORL Clinic, University of Foggia, Italy
- Enrico Heffler, MD
- Department of Biomedical Science-Humanitas University-Pieve Emanuele (MI), Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital-Rozzano (NI), Italy
- Clara Imperatore, MD
- AICNA, Asl Napoli 1 Centro Distretto 24 L. Crispi, Italy
- Cristiana Indolfi, MD
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania “Luigi Vanvitelli” Italy
- Massimo Landi, MD
- Department of Medical Sciences - Graduate School of Allergology and Clinical Immunology University of Turin, Italy
- Amelia Licari, MD
- SC Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Francesco Liotta, MD
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Italy
- Alberto Macchi, MD
- DBSV, Clinica ORL, Università Insubria, ASST-Settelaghi, Varese, Italy
- Luca Malvezzi, MD
- Otorinolaringoiatria e Chirurgia Cervico Facciale – Humanitas San Pio X Ambulatorio II Livello Rino-Allergologico IRCCS HumanitasResearch Hospital, Italy
- Sara Manti, MD
- Medico Chirurgo, Pediatra, Dottore di Ricerca, Ricercatore Tempo Determinato UOC Pediatria, AOU G. Martino, Università di Messina, Italy
- Francesco Menzella, MD
- UOC Pneumologia Distretto di Asolo, AULSS2 Marca Trevigiana, Italy
- Claudio Micheletto, MD
- UOC di Pneumologia, Azienda Ospedaliera Universitaria Verona, Veneto, Italy
- Fabio Midulla, MD
- Dipartimento Materno Infantile e Scienze Urologiche Policlinico Umberto I, Roma, Italy
- Michele Miraglia Del Giudice, MD
- Department of Medical Sciences - Graduate School of Allergology and Clinical Immunology University of Turin, Italy
- Antonino Musarra, MD
- Servizio di Allergologia, Casa della Salute di Scilla, ASP di Reggio Calabria, Italy
- Vincenzo Patella, MD
- UOC di Medicina Interna Ospedale Civile “Santa Maria della Speranza”, Salerno, Italy
- Diego Peroni, MD
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
- Laura Petrarca, MD
- Department of Maternal Infantile and Urological Science, Università“La Sapienza, Roma, Italy
- Giorgio Piacentini, MD
- UOC di Pediatria, AOUI Verona, Dipartimento di Scienze Chirurgiche, Odontostomatologiche e Materno-Infantili, Università di Verona, Italy
- Alessandro Pusateri, MD
- UOC Otorinolaringoiatria ASST Papa Giovanni XXIII Bergamo, Italy
- Veronica Seccia, MD, PhD
- ASP 6, Palermo, Italy
- Gianenrico Senna, MD
- Department of Medicine, Asthma Center, University of Verona, Italy
- Adriano Vaghi, MD
- ASST RodhensePneumologia, Italy
- Carlo Vancheri, PhD
- UOC Malattiedell’ApparatoRespiratorio, Università degli Studi di Catania, Italy
- Giovanni Passalacqua, MD
- Allergy and Respiratory Diseases, IRCCS PoliclinicoS.Martino, University of Genoa, Italy
- S. Arasi
- D. Bagnasco
- I. Baiardini
- S. Barbaglia
- F. Barosso
- R. Bernardini
- A. Berti
- B. Bilò
- L. Brussino
- F.R. Canevari
- G.W. Canonica
- C. Caruso
- A.A. Caruso
- A.G. Caviglia
- L. Cecchi
- P. Comberiati
- L. Cosmi
- M. Cottini
- M. Crivellaro
- D. Di Bona
- A. Fiocchi
- S. Frateiacci
- M. Gelardi
- G. Guida
- E. Heffler
- C. Incorvaia
- M. Landi
- M.A. Licari
- L. Malvezzi
- M. Milanese
- F. Mina
- E. Nettis
- G. Pala
- V. Patella
- D. Peroni
- S. Peveri
- F. Puggioni
- A. Pusateri
- O. Rossi
- E. Ridolo
- E. Savi
- J. Schroeder
- V. Seccia
- G.E. Senna
- M. Triggiani
- M. Uberti
- G. Varricchi
- M.T. Ventura
- M.T. Zedda
- DOI
- https://doi.org/10.1016/j.waojou.2025.101058
- Journal volume & issue
-
Vol. 18,
no. 5
p. 101058
Abstract
In recent years, it was recognized that type-2 inflammation connects nasal polyposis and severe asthma (SA) in addition to other type-2 diseases. Thus, some biological drugs developed for SA appeared to exert a favourable effect also in nasal polyposis. So far, there are several trials supporting this concept; therefore, some monoclonal antibodies already used for SA were assessed also in chronic rhinosinusistis with nasal polyposis (CRSwNP), with promising results.Since different specialists are involved in the management of nasal polyposis (eg, pulmonologists, ENT specialists, allergists, immunologists, pediatricians), it was felt that an updated educational and informative document was needed to better identify the indications of biological therapies in nasal polyposis. We collected the main Italian scientific societies, and prepared (under the umbrella of Allergic Rhinitis and its Impact on Asthma, ARIA) a document endorsed by all societies, to provide a provisional statement for the future use of monoclonal antibodies (MAbs) as a medical treatment for polyposis, possibly associated with SA. The above mentioned document was the first endorsed document on this aspect, and the additional evidence required an update. The current pathogenic knowledge and the experimental evidence are herein reviewed, and some suggestions for a correct prescription and follow-up are provided.
Keywords
- Chronic rhinosinusitis with nasal polyposis
- Severe asthma
- Biological agents
- Monoclonal antibodies
- ARIA (allergic rhinitis and its impact on asthma)
- Personalized medicine
