Management of chronic rhinosinusitis with nasal polyps in the Asia-Pacific region and Russia: Recommendations from an expert working group.

Autor:	Karpischenko S; ENT Department, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.; ENT Department, K.A. Rauhfus Children's City Multidisciplinary Clinical Center for High Medical Technologies, Saint Petersburg, Russia., Jung YG; Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Kim DW; Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea., Spriggs K; Department of Medicine, The University of Melbourne, Melbourne, Australia., Tsang RK; Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.; Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Yeh TH; Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.; Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	Asia Pacific allergy [Asia Pac Allergy] 2024 Jun; Vol. 14 (2), pp. 77-83. Date of Electronic Publication: 2024 Apr 04.
DOI:	10.5415/apallergy.0000000000000139
Abstrakt:	Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition of the nasal and paranasal tissues, characterized by the presence of bilateral nasal polyps. An expert panel of specialists from the Asian-Pacific region and Russia was convened to develop regional guidance on the management of CRSwNP through a consensus approach. The present article presents the chief observations and recommendations from this panel to provide guidance for clinicians in these areas. Etiology and pathogenetic mechanisms in CRSwNP are heterogeneous and complex. In many patients, CRSwNP is primarily driven by type 2 inflammation, although this may be less important in Asian populations. Frequent comorbidities include asthma and other inflammatory diseases such as non-steroidal anti-inflammatory drug (NSAID)/aspirin-exacerbated respiratory disease or atopic dermatitis. Clinical management of CRSwNP is challenging, and a multidisciplinary approach to evaluation and treatment is recommended. While many patients respond to medical treatment (topical irrigation and intranasal corticosteroids, and adjunctive short-term use of systemic corticosteroids), those with more severe/uncontrolled disease usually require endoscopic sinus surgery (ESS), although outcomes can be unsatisfactory, requiring revision surgery. Biological therapies targeting underlying type 2 inflammation offer additional, effective treatment options in uncontrolled disease, either as an alternative to ESS or for those patients with persistent symptoms despite ESS. Competing Interests: SK has been a speaker and lecturer for Sanofi, Medtronic, Storz, MSD, Solopharm, Bionorica; has received honoraria for advisory boards from Sanofi, Solopharm, Bionorica, MSD; has participated in clinical trials for Sanofi, Covance, Parexel, and GSK. KS has received grants and/or personal fees from ALK, AstraZeneca, Novartis, Sanofi Genzyme, Seqirus, Stallergenes-Greer; has been on the EAACI board for Allergen Immunotherapy; National Allergy Centre of Excellence (Australia) board for Insect Allergy; has been an advisor to InflaMed Pty Ltd. The remaining authors declare no conflicts of interest. (Copyright © 2024. Asia Pacific Association of Allergy, Asthma and Clinical Immunology.)
Databáze:	MEDLINE
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