Advances in the management of chronic rhinosinusitis with nasal polyps. Review of multidisciplinary strategies and innovations in biological treatments
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the upper airways, characterised by a type 2 (T2) immune response and frequently associated with respiratory comorbidities such as asthma, allergic rhinitis, and NSAID-exacerbated respiratory disease (N-ERD). Its management has evolved from a symptomatic medical-surgical treatment approach toward precision and personalised medicine, based on molecular-level knowledge of inflammatory endotypes. Biological therapies have shown efficacy in patients with severe uncontrolled disease, both sinonasal and bronchial, and are currently available within the Spanish healthcare system. However, key challenges remain: the lack of validated clinical biomarkers, uncertainty about the optimal duration of treatment, its combination with sinonasal surgery, and the high cost of biological therapies. In this context, the integration of data science and Big Data technologies in the Spanish healthcare system represents a strategic opportunity to generate real-world evidence, improve clinical decision-making, and advance toward a more equitable, efficient, and sustainable model of precision medicine.
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