A multidisciplinary Delphi consensus on budesonide aqueous nasal spray in managing upper respiratory diseases

Allergic rhinitis (AR), non-allergic rhinitis (NAR), and chronic rhinosinusitis with nasal polyps (CRSwNP) share a type 2 inflammation. Thus, intranasal corticosteroids (INCS) are recommended for managing these diseases. In this regard, budesonide aqueous nasal spray (BANS) has been an effective and safe INCS available for decades. As a recent Delphi consensus and a survey explored the use of topical nasal therapy in practice, a panel of experts promoted a multidisciplinary Delphi consensus on BANS in daily practice. Forty-six Italian expert otorhinolaryngologists, allergologists, and pediatricians participated in the initiative. Twenty-one statements were voted on. There was a large agreement with all statements. Thus, this document proposed a valuable BANS use in managing patients with AR, NAR, or CRSwNP considering the relevant activity on dampening type 2 inflammation. Moreover, the safety profile was considered good, also concerning the bioavailability issue. However, based on the severity of the disease, BANS use should be prescribed as cycles or for prolonged periods.  In conclusion, the present multidisciplinary Delphi consensus supported BANS use in upper airway type 2 diseases.