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Multidisciplinary Decision-Making—ITAlian Consensus After Two Years of Real Practice on the Management of Severe Uncontrolled CRSwNP by Biologics (ITACA Study)

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Abstract

Purpose of Review

We aimed to reach an Italian multidisciplinary consensus on some crucial aspects of treatment decision making in CRSwNP, following 2 years of clinical experience in order to support specialists in the management of CRSwNP in clinical practice. We addressed issues relating to therapeutic decision-making and shared criteria for the treatment choice, as well as appropriate timing and criteria for evaluating treatment response, and highlighted the need for repeated multidisciplinary assessments.

Recent Findings

A national survey has been conducted recently to understand how rhinology practice has changed in Italy with the advent of biologics and how this affects patients with uncontrolled, severe CRSwNP. Despite the many published consensus documents, practical recommendations, and protocols on the use of biologics in CRSwNP, heterogenous behaviors in practice are still observed mainly conditioned by the novelty of the topic.

Summary

The consensus procedure followed a modified Delphi approach. The scientific board included 18 otorhinolaryngologists and 8 allergists, who selected the 4 main topics to be addressed and developed overall 20 statements. Consensus on these statements was sought by a larger group of 48 additional experts, through two rounds of voting, the first web-based, the second in presence with discussion and possible refinement of the statements. The statements reaching an average score ≥ 7 at the second voting round were approved. Five statements were proposed for each of the following topics: baseline evaluation of patients eligible for biologic therapy; choice between different therapeutic options; assessment of the response to biologic treatment; multidisciplinary management. At the first voting round, 19 out of the 20 statements reached a mean score ≥ 7. Following the discussion and a few consequent amendments, at the second round of voting all the 20 statements were approved.

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Data Availability

No datasets were generated or analysed during the current study.

Change history

  • 20 April 2024

    The original version of this paper was updated to correct the family name of Matteo Alicandri Ciufelli.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Langdon C, Mullol J. Nasal polyps in patients with asthma: prevalence, impact, and management challenges. J Asthma Allergy. 2016;9:45–53. https://doi.org/10.2147/JAA.S86251.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lin DC, Chandra RK, Tan BK, et al. Association between severity of asthma and degree of chronic rhinosinusitis. Am J Rhinol Allergy. 2011;25(4):205–8. https://doi.org/10.2500/ajra.2011.25.3613.

    Article  PubMed  Google Scholar 

  3. Philpott CM, Erskine S, Hopkins C, et al. Prevalence of asthma, aspirin sensitivity and allergy in chronic rhinosinusitis: data from the UK National Chronic Rhinosinusitis Epidemiology Study. Respir Res. 2018;19(1):129. https://doi.org/10.1186/s12931-018-0823-y.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wu D, Bleier BS, Li L, et al. Clinical phenotypes of nasal polyps and comorbid asthma based on cluster analysis of disease history. J Allergy Clin Immunol Pract. 2018;6(4):1297-305.e1. https://doi.org/10.1016/j.jaip.2017.09.020.

    Article  PubMed  Google Scholar 

  5. •• Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58:1–464. https://doi.org/10.4193/Rhin20.600. First international guideline which emphasizes the role of the endotype as an essential prerequisite for precision medicine, providing the essential foundation for the start of the use of biologics in normal clinical practice.

    Article  PubMed  Google Scholar 

  6. Bachert C, Marple B, Schlosser RJ, Hopkins C, Schleimer RP, Lambrecht BN, et al. Adult chronic rhinosinusitis. Nat Rev Dis Primers. 2020;6(1):86. https://doi.org/10.1038/s41572-020-00218-1.

    Article  PubMed  Google Scholar 

  7. Wallace DV. Treatment options for chronic rhinosinusitis with nasal polyps. Allergy Asthma Proc. 2021;42(6):450–60. https://doi.org/10.2500/aap.2021.42.210080.

    Article  CAS  PubMed  Google Scholar 

  8. • De Corso E, Bellocchi G, De Benedetto M, Lombardo N, Macchi A, Malvezzi L, et al. Biologics for severe uncontrolled chronic rhinosinusitis with nasal polyps: a change management approach. Consensus of the Joint Committee of Italian Society of Otorhinolaryngology on biologics in rhinology. Acta Otorhinolaryngol Ital. 2022;42(1):1–16. https://doi.org/10.14639/0392-100X-N1614. First Italian position paper published after the approval of biologics in Italy in which the value of multidisciplinarity is greatly stressed.

  9. De Corso E, Pipolo C, Cantone E, Ottaviano G, Gallo S, Canevari FRM, et al. Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs. J Pers Med. 2022;12(6):897. https://doi.org/10.3390/jpm12060897.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bachert C, Han JK, Wagenmann M, et al. EUFOREA expert board meeting on uncontrolled severe chronic rhinosinusitis with nasal polyps (CRSwNP) and biologics: definitions and management. J Allergy Clin Immunol. 2021;147(1):29–36.

    Article  CAS  PubMed  Google Scholar 

  11. • De Corso E, Ottaviano G, Pipolo C, Cantone E, Mattavelli D, Alicandri-Ciufelli M, et al. Chronic Rhinosinusitis with Nasal Polyps: A Survey on Routine Management and Evaluation of Disease Control in Practice. J Pers Med. 2023;13(11):1531. https://doi.org/10.3390/jpm13111531. Italian survey from which the need for a clinical definition of disease control in clinical practice and for specific tools to measure it clearly emerges.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Tomassen P, Vandeplas G, Van Zele T, Cardell LO, Arebro J, Olze H, et al. Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers. J Allergy Clin Immunol. 2016;137(5):1449-56.e4. https://doi.org/10.1016/j.jaci.2015.12.1324.

    Article  CAS  PubMed  Google Scholar 

  13. Bachert C, Zhang N, Hellings PW, Bousquet J. Endotype-driven care pathways in patients with chronic rhinosinusitis. J Allergy Clin Immunol. 2018;141(5):1543–51. https://doi.org/10.1016/j.jaci.2018.03.004.

    Article  PubMed  Google Scholar 

  14. De Greve G, Hellings PW, Fokkens WJ, Pugin B, Steelant B, Seys SF. Endotype-driven treatment in chronic upper airway diseases. Clin Transl Allergy. 2017;7:22. https://doi.org/10.1186/s13601-017-0157-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Bachert C, Han JK, Desrosiers M, Hellings PW, Amin N, Lee SE, et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet. 2019;394:1638–50. https://doi.org/10.1016/S0140-6736(19)31881-1.

    Article  CAS  PubMed  Google Scholar 

  16. van der Lans RJL, Fokkens WJ, Adriaensen GFJPM, Hoven DR, Drubbel JJ, Reitsma S. Real-life observational cohort verifies high efficacy of dupilumab for chronic rhinosinusitis with nasal polyps. Allergy 2022;77:670–4. https://doi.org/10.1111/all.15134.

  17. Gevaert P, Omachi TA, Corren J, Mullol J, Han J, Lee SE, et al. Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials. J Allergy Clin Immunol. 2020;146(3):595–605. https://doi.org/10.1016/j.jaci.2020.05.032.

    Article  CAS  PubMed  Google Scholar 

  18. Gevaert P, Saenz R, Corren J, Han JK, Mullol J, Lee SE, et al. Long-term efficacy and safety of omalizumab for nasal polyposis in an open-label extension study. J Allergy Clin Immunol. 2022;149(3):957-65.e3. https://doi.org/10.1016/j.jaci.2021.07.045.

    Article  CAS  PubMed  Google Scholar 

  19. Desrosiers M, Diamant Z, Castelnuovo P, Hellings PW, Han JK, Peters AT, et al. Sustained efficacy of mepolizumab in patients with severe chronic rhinosinusitis with nasal polyps: SYNAPSE 24-week treatment-free follow-up. Int Forum Allergy Rhinol. 2023;14(1):18–31. https://doi.org/10.1002/alr.23219.

    Article  PubMed  Google Scholar 

  20. Hopkins C, Han JK, Lund VJ, Bachert C, Fokkens WJ, Diamant Z, et al. Evaluating treatment response to mepolizumab in patients with severe CRSwNP. Rhinology. 2023;61(2):108–17. https://doi.org/10.4193/Rhin22.200.

    Article  CAS  PubMed  Google Scholar 

  21. • De Corso E, Pipolo C, Cantone E, Ottaviano G, Gallo S, Trimarchi M, et al. Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics. Acta Otorhinolaryngol Ital. 2023;43(5):324–40. https://doi.org/10.14639/0392-100X-N2422 . Italian position paper which highlights through a survey the needs that emerge from the daily use of biologics in normal clinical practice.

  22. •• Fokkens WJ, Lund V, Bachert C, Mullol J, Bjermer L, Bousquet J, et al. EUFOREA consensus on biologics for CRSwNP with or without asthma. Allergy. 2019;74:2312–9. https://doi.org/10.1111/all.13875. First paper in which the criteria for the indication of CRSwNPs to biological drugs are defined.

    Article  PubMed  Google Scholar 

  23. De Corso E, Bilò MB, Matucci A, Seccia V, Braido F, Gelardi M, et al. Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement. J Pers Med. 2022;12(5):846. https://doi.org/10.3390/jpm12050846.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lombardi C, Asero R, Bagnasco D, Blasi F, Bonini M, Bussi M, et al. ARIA-ITALY multidisciplinary consensus on nasal polyposis and biological treatments. World Allergy Organ J. 2021;14: 100592. https://doi.org/10.1016/j.waojou.2021.100592.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Hopkins C, McKenzie JL, Anari S, Carrie S, Ramakrishnan Y, Kara N, et al. British Rhinological Society consensus guidance on the use of biological therapies for chronic rhinosinusitis with nasal polyps. Clin Otolaryngol. 2021;46:1037–43. https://doi.org/10.1111/coa.13779.

    Article  PubMed  Google Scholar 

  26. •• Fokkens WJ, De Corso E, Backer V, Bernal-Sprekelsen M, Bjermer L, von Buchwald C, et al. EPOS2020/EUFOREA expert opinion on defining disease states and therapeutic goals in CRSwNP. Rhinology. 2024 Jan 13. https://doi.org/10.4193/Rhin23.415. Epub ahead of print. PMID: 38217529. Expert opinion including new definitions such as Control of disease and Remission.

  27. Thamboo A, Kilty S, Witterick I, Chan Y, Chin CJ, Janjua A, et al. Canadian Rhinology Working Group consensus statement: biologic therapies for chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2021;50:15. https://doi.org/10.1186/s40463-021-00493-2.

    Article  Google Scholar 

  28. Loblaw DA, Prestrud AA, Somerfield MR, Oliver TK, Brouwers MC, Nam RK, et al. American Society of Clinical Oncology Clinical Practice Guidelines: formal systematic review-based consensus methodology. J Clin Oncol. 2012;30(25):3136–40. https://doi.org/10.1200/JCO.2012.42.0489.

    Article  PubMed  Google Scholar 

  29. Humphrey-Murto S, Varpio L, Wood TJ, Gonsalves C, Ufholz LA, Mascioli K, et al. The Use of the Delphi and Other Consensus Group Methods in Medical Education Research: A Review. Acad Med. 2017;92(10):1491–8. https://doi.org/10.1097/ACM.0000000000001812.

    Article  PubMed  Google Scholar 

  30. •• Fokkens WJ, Viskens AS, Backer V, Conti D, De Corso E, Gevaert P, et al. EPOS/EUFOREA update on indication and evaluation of Biologics in Chronic Rhinosinusitis with Nasal Polyps 2023. Rhinology. 2023;61(3):194–202. https://doi.org/10.4193/Rhin22.489. Important update on indications for biologics and evaluation of success.

    Article  CAS  PubMed  Google Scholar 

  31. Khoury P, Akuthota P, Kwon N, Steinfeld J, Roufosse F. HES and EGPA: Two Sides of the Same Coin. Mayo Clin Proc. 2023;98(7):1054–70. https://doi.org/10.1016/j.mayocp.2023.02.013.

    Article  CAS  PubMed  Google Scholar 

  32. Cantone E, De Corso E, Ricciardiello F, Di Nola C, Grimaldi G, Allocca V, et al. Olfaction recovery following dupilumab is independent of nasal polyp reduction in CRSwNP. J Pers Med. 2022;12:1215. https://doi.org/10.2174/1570159X20666220420113513.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Wu Q, Zhang Y, Kong W, Wang X, Yuan L, Zheng R, et al. Which Is the Best Biologic for Nasal Polyps: Dupilumab, Omalizumab, or Mepolizumab? A Network Meta-Analysis. Int Arch Allergy Immunol. 2022;183(3):279–88. https://doi.org/10.1159/000519228.

    Article  CAS  PubMed  Google Scholar 

  34. Shen Y, Ke X, Hong S, Yang Y. Adverse events for biologics in patients with CRSwNP: A meta-analysis. Clin Transl Allergy. 2022;12(6): e12169. https://doi.org/10.1002/clt2.12169.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Reitsma S, Adriaensen G, Cornet ME, van Haastert RM, Raftopulos MH, Fokkens WJ. The Amsterdam Classification of Completeness of Endoscopic Sinus Surgery (ACCESS): a new CT-based scoring system grading the extent of surgery. Rhinology. 2020;58(6):538–43. https://doi.org/10.4193/Rhin20.165.

    Article  CAS  PubMed  Google Scholar 

  36. Loftus CA, Soler ZM, Desiato VM, Koochakzadeh S, Yoo F, Storck KA, et al. Factors impacting revision surgery in patients with chronic rhinosinusitis with nasal polyposis. Int Forum Allergy Rhinol. 2020;10(3):289–302. https://doi.org/10.1002/alr.22505.

    Article  PubMed  Google Scholar 

  37. •• Sedaghat AR, Caradonna DS, Chandra RK, Franzese C, Gray ST, Halderman AA, et al. Determinants of physician assessment of chronic rhinosinusitis disease control using EPOS 2020 criteria and the importance of incorporating patient perspectives of disease control. Int Forum Allergy Rhinol. 2023;13(11):2004–17. https://doi.org/10.1002/alr.23168. Important article where for the first time the importance of the patient's perception in the definition of disease control is underlined by Delphi method.

    Article  PubMed  Google Scholar 

  38. Busse WW, Melén E, Menzies-Gow AN. Holy Grail: the journey towards disease modification in asthma. Eur Respir Rev. 2022;31(163): 210183. https://doi.org/10.1183/16000617.0183-2021.

    Article  PubMed  PubMed Central  Google Scholar 

  39. •• Caminati M, De Corso E, Ottaviano G, Pipolo C, Schiappoli M, Seccia V, et al. Remission in Type 2 Inflammatory Diseases: Current Evidence, Unmet Needs, and Suggestions for Defining Remission in Chronic Rhinosinusitis with Nasal Polyps. Curr Allergy Asthma Rep. 2024;24(1):11–23. https://doi.org/10.1007/s11882-023-01118-6. Systematic review on the need to define remission in nasal polyposis starting from the definitions of other type 2 diseases.

    Article  PubMed  Google Scholar 

  40. Saydy N, Moubayed SP, Bussières M, Janjua A, Kilty S, Lavigne F, et al. What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts. J Otolaryngol Head Neck Surg. 2021;50(1):36. https://doi.org/10.1186/s40463-021-00519-9.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Chan Y, Thamboo AV, Han JK, Desrosiers M. Remission: does it already exist in chronic rhinosinusitis with nasal polyposis? J Otolaryngol Head Neck Surg. 2023;52(1):50. https://doi.org/10.1186/s40463-023-00657-2.

    Article  PubMed  PubMed Central  Google Scholar 

  42. De Corso E, Settimi S, Montuori C, Cantiani A, Corbò M, Di Bella GA, et al. How to manage recurrences after surgery in CRSwNP patients in the biologic era: a narrative review. Acta Otorhinolaryngol Ital. 2023;43(Suppl. 1):S3-S13. https://doi.org/10.14639/0392-100X-suppl.1-43-2023-01 .

  43. Jarvis D, Newson R, Lotvall J, Hastan D, Tomassen P, Keil T, et al. Asthma in adults and its association with chronic rhinosinusitis: The GA2LEN survey in Europe. Allergy. 2012;67:91–8. https://doi.org/10.1111/j.1398-9995.2011.02709.x.

    Article  CAS  PubMed  Google Scholar 

  44. Seccia V, D’Amato M, Scioscia G, Bagnasco D, Di Marco F, Fadda G, et al. Management of Patients with Severe Asthma and Chronic Rhinosinusitis with Nasal Polyps: A Multidisciplinary Shared Approach. J Pers Med. 2022;12(7):1096. https://doi.org/10.3390/jpm12071096.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Laidlaw TM, Mullol J, Woessner KM, Amin N, Mannent LP. Chronic Rhinosinusitis with Nasal Polyps and Asthma. J Allergy Clin Immunol Pract. 2021;9(3):1133–41. https://doi.org/10.1016/j.jaip.2020.09.063.

    Article  CAS  PubMed  Google Scholar 

  46. Castro M, Corren J, Pavord ID, Maspero J, Wenzel S, Rabe KF, et al. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma. N Engl J Med. 2018;378(26):2486–96. https://doi.org/10.1056/NEJMoa1804092.

    Article  CAS  PubMed  Google Scholar 

  47. Pavord ID, Hanania NA, Corren J. Controversies in allergy: choosing a biologic for patients with severe asthma. J Allergy Clin Immunol Pract. 2022;10(2):410–9. https://doi.org/10.1016/j.jaip.2021.12.014.

    Article  PubMed  Google Scholar 

  48. Otten J, van der Lans R, de Corso E, Dziadziulia K, Hilvering B, Weersink E, et al. Evaluation of switching or simultaneous use of biologic treatment in patients with severe chronic rhinosinusitis with nasal polyps and severe asthma. Considerations in clinical decision making. Expert Rev Clin Immunol. 2023;19(8):1041–9. https://doi.org/10.1080/1744666X.2023.2218617.

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Acknowledgements

We would like to thank Renata Perego, MD, an independent medical writer, for her help in drafting the manuscript. We extend our sincere gratitude to all participants who contributed to the Delphi process. Their valuable insights and thoughtful responses have been instrumental in shaping our understanding and decision-making. For that reasons we thank Francesca Anastasi; Roberta Anzivino; Gabriele Arra; Giovanni Bastanza; Elisabetta Bison; Andrea Ciofalo; Maria Angiola Crivellaro; Giuseppe D’agostino; Giulia Dane’; Leandro Maria Dauria; Alessio De Massimi; Albarosa De Pascale; Carla De Vita; Valeria Dell’era; Giovanni Delu; Francesca Di Lallo; Gianluca Fadda; Francesco Fiorino; Cosimo Galletti; Giorgio Oliviero Gallone; Maria Stella Garritani; Angela Gasparini; Alessia Giorli; Luca Guastini; Antonella Loperfido; Lucia Lora; Simonetta Masieri; Claudio Montuori; Patrick Pinter; Davide Paolo Porru; Alessandro Pusateri; Martina Ragusa; Cecilia Rosso; Paolo Russo; Tommaso Saccardo; Giampiero Salonna; Daria Salsi; Mariella Scarano; Federico Sireci; Fabio Sovardi; Paolo Antiuco Uras.

Author information

Authors and Affiliations

  1. Otolaryngology, Head and Neck Surgery, Rhinology, A. Gemelli University Hospital Foundation, IRCSS, Rome, Italy

    Eugenio De Corso

  2. Department of Health Sciences, Otolaryngology Unit, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy

    Carlotta Pipolo

  3. Department of Medicine, Allergy Unit and Asthma Center, University of Verona, Verona University Hospital, Verona, Italy

    Marco Caminati & Gianenrico Senna

  4. Department of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, Italy. Head and Neck Department-ENT Section, University of Naples, AOU Federico II, 29 Federico II, 80131, Naples, Italy

    Elena Cantone

  5. Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy

    Veronica Seccia

  6. SOSD Allergology and Clinical Immunology, Ospedale S. Stefano, USL Toscana Centro, Prato, Italy

    Lorenzo Cecchi

  7. Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, Bari, Italy

    Eustachio Nettis

  8. Department of Otorhinolaryngology, Rhinology Unit, Eastern Piedmont University – Maggiore Hospital, Novara, Italy

    Massimiliano Garzaro

  9. Department of Neurosciences, Otolaryngology Section, University of Padova, Padua, Italy

    Giancarlo Ottaviano

  10. Unit of Otolaryngology, University of Foggia, Foggia, Italy

    Matteo Gelardi

  11. Department of Sense Organs, Sapienza University of Rome, Rome, Italy

    Carlo Cavaliere

  12. Personalized Medicine Asthma and Allergy Unit - IRCCS Humanitas Research Hospital, Milan, Italy

    Enrico Heffler

  13. Department of Biomedical Sciences, Humanitas University, Milan, Italy

    Enrico Heffler

  14. Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

    Fabio Pagella

  15. IRCCS Policlinico San Matteo, Pavia, Italy

    Fabio Pagella

  16. Otorhinolaryngology Unit, Ospedale Bellaria Dip Chirurgie Specialistiche AUSL BO, Bologna, Italy

    Ernesto Pasquini

  17. Department of Otolaryngology-Head and Neck Surgery, Ente Ospedaliero Cantonale, Ospedale Regionale Di Lugano, Università Della Svizzera Italiana, Lugano, Svizzera, Italy

    Matteo Trimarchi

  18. Head and Neck Department, ASST Sette Laghi and UPLOAD Research Center, Otorinolaryngology Unit, University of Insubria, Varese, Italy

    Stefania Gallo

  19. Department of Medical - Surgical Sciences and Advanced Technologies-G.F. Ingrassia Director of E.N.T. Unit, P.O.G. Rodolico University of Catania, Catania, Italy

    Ignazio La Mantia

  20. Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Sara Torretta

  21. Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili Brescia, University of Brescia, 25123, Brescia, Italy

    Davide Mattavelli

  22. Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

    Cristiano Caruso

  23. Immunoallergoly Unit, Careggi University Hospital, Florence-Largo Brambilla, 3-50134, Florence, Italy

    Andrea Matucci & Alessandra Vultaggio

  24. Department of Otolaryngology, San Camillo Forlanini Hospital, Rome, Italy

    Gianluca Bellocchi

  25. Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Di Modena, Modena, Italy

    Matteo Alicandri Ciufelli

  26. Unit of ENT, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy

    Passali FM

Authors
  1. Eugenio De Corso
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  2. Carlotta Pipolo
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  3. Marco Caminati
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  4. Elena Cantone
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  5. Veronica Seccia
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  6. Lorenzo Cecchi
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  7. Eustachio Nettis
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  8. Massimiliano Garzaro
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  9. Giancarlo Ottaviano
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  10. Matteo Gelardi
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  11. Carlo Cavaliere
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  12. Enrico Heffler
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  13. Fabio Pagella
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  14. Ernesto Pasquini
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  15. Matteo Trimarchi
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  16. Stefania Gallo
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  17. Ignazio La Mantia
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  18. Sara Torretta
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  19. Davide Mattavelli
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  20. Cristiano Caruso
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  21. Andrea Matucci
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  22. Alessandra Vultaggio
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  23. Gianluca Bellocchi
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  24. Matteo Alicandri Ciufelli
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  25. Passali FM
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  26. Gianenrico Senna
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Contributions

EDC: conceptualization, writing original draft, resources, methodology, editing, supervision, statements discussion and validation. CP, EC, MC, VS methodology, critical revision, statements discussion and validation. LC, EN, MG, GO, MG, CC, EH, FP, EP, MT, SG, ILM, ST, DM, CC, AM, AV, GB, MAC, PFM, statements discussion and validation, critical revision. GS supervision, statements discussion and validation, critical revision, final approval & editing. All authors have read and agreed to the published final version of the manuscript.

Corresponding author

Correspondence to Eugenio De Corso.

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EDC has received fees for consultation, speaker activity, and advisory boards from Sanofi, Regeneron, GlaxoSmithKline (GSK), Novartis and AstraZeneca. GO has received fees for consultation, speaker activity, and served on advisory boards for Sanofi, GSK, and Novartis. CP has received fees for consultation, speaker activity, advisory boards from Sanofi, Regeneron, GSK, Novartis, Chiesi, Firma. EC has received lecture fees from and participated in experts’ board meetings of GSK, Novartis, Sanofi, NOOS, and AstraZeneca. MC has received speaker and consultancy fees from Astra Zeneca, GSK, and Sanofi. CC has received lecture fees and participated in experts’ board meetings of GSK, Novartis, and Sanofi. G Senna has received speaker fees from Sanofi, AstraZeneca, and GSK. ST fees for lectures and advisory boards for GSK and SANOFI. VS has received lecture fees and participated in experts’ board meetings of GSK, Novartis, Sanofi, and AstraZeneca. MG has received lecture fees and participated in experts’ board meetings of GSK and Sanofi. MT has received consulting fees from Sanofi, GSK, and Novartis. FP has received consulting fees from Sanofi, Novartis, Chiesi, Menarini, Firma, and Deca. FRC has received lecture fees and participated in experts board meetings of GSK, Novartis, and Sanofi. ILM has received lecture fees and participated in experts’ board meetings of Sanofi. The other authors declare no conflict of interest. LC has received fees for consultation, speaker activity, and advisory boards from Sanofi, GlaxoSmithKline (GSK), Novartis, Menarini, Thermofisher, ALK and AstraZeneca. EN has received speaker and consultancy fees from Abbvie, Leo-Pharma, Novartis, Astra Zeneca, GSK, and Sanofi. MAC has received fees for consultation, speaker activity, advisory boards from Sanofi. GB has received lecture fees and participated in experts’ board meetings of Sanofi, GSK, Novartis, Abiogen, Aurora Biopharma. CC has received fees for consultation, speaker activity, and advisory boards from Sanofi, GlaxoSmithKline (GSK), menarini, Chiesi and AstraZeneca. MG has received advisory board fees or speaker fees from GlaxoSmithKline, Novartis, Sanofi-Genzyme, Valeas, DMG Italia, FIRMA, Aurora Biofarma, and Fenix Pharma. EH has received speaker activity and advisory board participation fees from Novartis, GlaxoSmithKline, Sanofi, Regeneron, AstraZeneca, Stallergenes-Greer, Circassia, and Nestlè Purina. AM has received speaker’s fees from Amicus Therapeutics, AstraZeneca, GSK, Novartis, Sanofi and Takeda and honoraria for attending advisory board meetings with, AstraZeneca, GSK, Novartis, Sanofi and Chiesi. AV has received speaker’s fees from AstraZeneca, GSK, Novartis, Sanofi and Chiesi and honoraria for attending advisory board meetings with, AstraZeneca, GSK, Novartis, Sanofi. PFM has received lecture fees and participated in experts board meetings of GSK and Sanofi. EP, SG, DM, has none conflict of interest. GS has received speaker fee and research grant by AstraZeneca, GSK, Novartis, Sanofi.

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De Corso, E., Pipolo, C., Caminati, M. et al. Multidisciplinary Decision-Making—ITAlian Consensus After Two Years of Real Practice on the Management of Severe Uncontrolled CRSwNP by Biologics (ITACA Study). Curr Allergy Asthma Rep 24, 143–154 (2024). https://doi.org/10.1007/s11882-024-01135-z

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