Reconsidering biologic treatment recommendations for CRSwNP without asthma in EUFOREA guidelines

Area of Science:

• Respiratory Medicine
• Clinical Immunology

Background:

• Biologics are increasingly used for upper and lower airway diseases.
• The EUFOREA pocket guide provides recommendations for biologic use in chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma.
• Current recommendations are based on expert opinion and indirect treatment comparisons due to a lack of head-to-head studies.

Purpose of the Study:

• To summarize recommendations on biologic use in CRSwNP and asthma.
• To offer guidance on biologic choice for clinicians treating these conditions.
• To highlight additional considerations for biologic selection and classification.

Main Methods:

• Review of expert opinions.
• Analysis of published indirect treatment comparison (ITC) data.
• Synthesis of evidence for biologic therapy in CRSwNP and asthma.

Main Results:

• A single preferred biologic is recommended for CRSwNP without concomitant asthma.
• Different biologic options are suggested for various asthma endotypes and phenotypes.
• The guide aims to aid clinicians in making informed biologic treatment choices.

Conclusions:

• The EUFOREA pocket guide serves as a valuable resource for clinicians.
• Further considerations beyond the guide's recommendations may be necessary for optimal patient care.
• Classification and selection of biologics require careful attention in complex airway diseases.