Remission in chronic rhinosinusitis with nasal polyps (CRSwNP)

Area of Science:

• Otolaryngology
• Allergy and Immunology
• Respiratory Medicine

Background:

• Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) management traditionally focused on symptom control.
• Persistent symptoms often remain despite conventional therapies, necessitating new treatment paradigms.

Purpose of the Study:

• To introduce and define remission as the new goal of care for CRSwNP.
• To highlight the shift from symptom control to a sustained state of remission.

Main Methods:

• Literature review and synthesis of expert recommendations (EUFOREA/EPOS).
• Definition of remission criteria for CRSwNP: 12 months of symptom control, no oral corticosteroids or endoscopic sinus surgery (ESS), and no active endoscopic disease.

Main Results:

• Remission is defined as a prolonged state of disease control.
• This state requires no bothersome symptoms, oral corticosteroids, or ESS for at least 12 months.
• It also requires the absence of endoscopic signs of active disease.

Conclusions:

• Remission represents a more ambitious and achievable goal for CRSwNP patients.
• New therapies, including biologics, offer potential for achieving this remission state.
• The ENT community and patients should embrace remission as the primary objective in CRSwNP care.