Lombardi Carlo, Canevari Rikki F, Bagnasco Diego, Bilò Maria Beatrice, Canonica Giorgio Walter, Caruso Cristiano, Castelnuovo Paolo, Cecchi Lorenzo, Calcinoni Orietta, Carone Mauro, Cassatella Marco, Cutrera Renato, Danesi Gianni, De Corso Eugenio, Di Gioacchino Mario, Di Marco Fabiano, Gallo Stefania, Gelardi Matteo, Heffler Enrico, Imperatore Clara, Indolfi Cristiana, Landi Massimo, Licari Amelia, Liotta Francesco, Macchi Alberto, Malvezzi Luca, Manti Sara, Menzella Francesco, Micheletto Claudio, Midulla Fabio, Miraglia Del Giudice Michele, Musarra Antonino, Patella Vincenzo, Peroni Diego, Petrarca Laura, Piacentini Giorgio, Pusateri Alessandro, Seccia Veronica, Senna Gianenrico, Vaghi Adriano, Vancheri Carlo, Passalacqua Giovanni
Unit of Allergology, Clinical Immunology & Respiratory Diseases, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Dipartimento DISC, Clinica Otorinolaringoiatria, IRCCS Policlinico San Martino, Università di Genova, Italy.
World Allergy Organ J. 2025 May 9;18(5):101058. doi: 10.1016/j.waojou.2025.101058. eCollection 2025 May.
In recent years, it was recognized that type-2 inflammation connects nasal polyposis and severe asthma (SA) in addition to other type-2 diseases. Thus, some biological drugs developed for SA appeared to exert a favourable effect also in nasal polyposis. So far, there are several trials supporting this concept; therefore, some monoclonal antibodies already used for SA were assessed also in chronic rhinosinusistis with nasal polyposis (CRSwNP), with promising results. Since different specialists are involved in the management of nasal polyposis (eg, pulmonologists, ENT specialists, allergists, immunologists, pediatricians), it was felt that an updated educational and informative document was needed to better identify the indications of biological therapies in nasal polyposis. We collected the main Italian scientific societies, and prepared (under the umbrella of Allergic Rhinitis and its Impact on Asthma, ARIA) a document endorsed by all societies, to provide a provisional statement for the future use of monoclonal antibodies (MAbs) as a medical treatment for polyposis, possibly associated with SA. The above mentioned document was the first endorsed document on this aspect, and the additional evidence required an update. The current pathogenic knowledge and the experimental evidence are herein reviewed, and some suggestions for a correct prescription and follow-up are provided.
近年来，人们认识到2型炎症除了与其他2型疾病相关外，还将鼻息肉病与重度哮喘（SA）联系起来。因此，一些为SA研发的生物药物似乎对鼻息肉病也有良好疗效。到目前为止，有多项试验支持这一概念；因此，一些已用于SA的单克隆抗体也在伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）中进行了评估，结果令人鼓舞。由于鼻息肉病的管理涉及不同的专科医生（如肺科医生、耳鼻喉科专家、过敏症专科医生、免疫学家、儿科医生），人们认为需要一份更新的教育和信息文件，以更好地确定生物疗法在鼻息肉病中的适应证。我们召集了意大利主要的科学学会，并（在变应性鼻炎及其对哮喘的影响，即ARIA的框架下）编写了一份得到所有学会认可的文件，为单克隆抗体（MAbs）未来作为息肉病（可能与SA相关）的药物治疗提供一份临时声明。上述文件是这方面的第一份认可文件，而更多的证据需要更新。本文回顾了当前的致病知识和实验证据，并提供了一些正确处方和随访的建议。
