• Special Issue Topic

    Update on Chronic RhinoSinusitis

    Submission Deadline: May 31, 2024

    Guest Editor

    Prof. Ludger Klimek E-Mail

    Head and Chairman Center for Rhinology and Allergology, Wiesbaden, Germany

    Research Keywords: Allergic rhinitis, allergen immunotherapy, ASA intolerance / N-ERD syndrome, chronic rhinosinusitis / CRSwNP, epithelial immunology


    About the Special Issue

    Chronic rhinosinusitis (CRS) is a common chronic disease in Europe, the Americas and Asia with prevalences of 7% to 16%. CRSwNP is a subtype of CRS that accounts for the majority of health care costs with a prevalence of approximately 4% in the adult population and is associated with significantly impaired health-related quality of life. In CRSwNP, recurrence is common despite adequate drug and surgical treatment.

    Drug treatment of CRSwNP targets the underlying inflammation and includes topical intranasal corticosteroids, short-term systemic corticosteroids (SCS) and others like e.g. leucotrien-antagonists, nasal lavage and antibiotics. Sinus surgery is an option for patients whose symptoms persist despite appropriate drug treatment but patients with severe CRSwNP have a recurrence rate of ca. 40% within three years, even when multimodal treatment methods have been used  and of up to 80% within 12 years. Therefore, additional treatment options are needed and modern biologicals like Dupilumab, Mepolizumab and Omalizumab are authorized for severe CRSwNP. Biologic therapy targets type 2 inflammation that is found in approximately 80% of patients with CRSwNP in Europe and is associated more often with comorbid asthma. Aspirin-exacerbated airway disease (AERD or N-ERD) patients are more likely to require sinus surgery, have high corticosteroid use, and are more likely to experience long-term recurrence. Advances in the understanding of the immunologic processes involved in type 1, 2 and 3-inflammation will lead to new opportunities for disease control and monoclonal antibodies targeting other immunological players will soon become available.

    International recommendations exist for the indication and in-label therapy of CRSwNP with biologics and will be further developed for monitoring the course and efficacy of therapy as well as for reviewing the duration and possible termination of therapy considering pharmacoeconomic aspects, taking into account the high cost of biologics. 

    Keywords: Chronic rhinosinusitis, biologic therapy, biologicals, asthma

    Call for Papers

    Published Articles

    Open Access
    Review
    Evaluation of ongoing mepolizumab treatment in chronic rhinosinusitis with nasal polyps
    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial inflammatory disease of the mucous membranes of the nose and paranasal sinuses. Eosinophilic inflammation is described as a comm [...] Read more.
    Ludger Klimek ... Claus Bachert
    Published: February 22, 2024 Explor Asthma Allergy. 2024;2:33–48
    DOI: https://doi.org/10.37349/eaa.2024.00027
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