Abstract
Following the European Forum for Research and Education in Allergy and
Airway Diseases (EUFOREA) treatment algorithm for chronic rhinosinusitis
(CRS) with nasal polyps (CRSwNP), patients suffering from severe
uncontrolled CRSwNP are recommended to receive oral corticosteroids,
(revision) sinus surgery, systemic biologicals, and/or aspirin treatment
after desensitization (ATAD). Given the major differences in
indications, outcomes, practical considerations, risks and costs of
these key pillars of treatment, there is a growing need to define
criteria for each treatment option and list the clinically relevant and
major considerations for them. This EUFOREA document therefore provides
an expert panel overview of the expected outcomes, specific
considerations and (contra)indications of the five major treatment arms
of severe uncontrolled CRSwNP: oral corticosteroids, primary and
revision sinus surgery, biological treatment, and ATAD. This overview of
treatment considerations is needed to allow physicians and patients to
consider the different options in the context of providing optimal and
personalized care for severe uncontrolled CRSwNP. In conclusion, the
five major treatment options for severe uncontrolled CRSwNP have
intrinsic advantages, specific indications, and considerations that are
of importance to the patient, the physician, and the society. This
EUFOREA statement supports the unmet need to define criteria for the
indication of every treatment pillar of CRSwNP.