EUFOREA/EPOS2020 statement on the clinical considerations for chronic rhinosinusitis with nasal polyps care

Peter W. Hellings, Isam Alobid, Wilma T. Anselmo-Lima, Manuel Bernal-Sprekelsen, Leif Bjermer, Lisa Caulley, Adam Chaker, Jannis Constantinidis, Diego M. Conti, Eugenio De Corso, Martin Desrosiers, Zuzana Diamant, Philippe Gevaert, Joseph K. Han, Enrico Heffler, Claire Hopkins, Basile N. Landis, Olga Lourenco, Valerie Lund, Amber U. LuongJoaquim Mullol, Anju Peters, Carl Philpott, Sietze Reitsma, Dermot Ryan, Glenis Scadding, Brent Senior, Peter Valentin Tomazic, Elina Toskala, Thibaut van Zele, An-Sofie Viskens, Martin Wagenmann, W. J. Fokkens

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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.

Original languageEnglish
Pages (from-to)1123-1133
Number of pages11
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number5
Early online date18 Dec 2023
Publication statusPublished - May 2024


  • aspirin intolerance
  • biologics
  • corticosteroids
  • CRSwNP
  • sinus surgery

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