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Purpose of Review <p>This review synthesizes current evidence and expert consensus on the long-term management of severe chronic rhinosinusitis with nasal polyps (CRSwNP) treated with biologics, as established by the Italian CHRONOS project.</p> Recent Findings <p>Accumulating real-world and clinical trial data confirm the sustained efficacy and safety of biologics targeting type 2 inflammation, enabling durable control and remission in a significant proportion of patients. Personalized dosing regimens, including dose-spacing strategies, appear feasible.</p> Summary <p>The CHRONOS project provides practical guidance for optimizing long-term biologic therapy in severe CRSwNP. Response assessment should combine subjective and objective measures, especially for olfactory testing. Biologics may be considered before surgery only in selected complex cases. Dose-spacing strategies may be appropriate in stable patients but require multidisciplinary oversight in those with comorbid asthma. Adverse events are uncommon. The concept of disease modification is endorsed, recognizing biologics’ potential to alter the natural history of CRSwNP.</p>

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Chronic Rhinosinusitis Optimisation of Nasal Outcomes and Scores (CHRONOS): An Italian Delphi Consensus on Long-Term Management with Biologics

  • 期刊论文

  • 发表日期：

    2026年1月9日

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  • Eugenio De Corso,
  • Frank Rikki Mauritz Canevari,
  • Marco Caminati,
  • Carlotta Pipolo,
  • Enrico Heffler,
  • Matteo Lazzeroni,
  • Veronica Seccia,
  • Massimiliano Garzaro,
  • Giancarlo Ottaviano,
  • Elena Cantone,
  • Fabio Pagella,
  • Giulia Gramellini,
  • Ignazio La Mantia,
  • Stefania Gallo,
  • Antonio Moffa,
  • Ernesto Pasquini,
  • Antonella Loperfido,
  • Sara Torretta,
  • Lorenzo Cecchi,
  • Gian Luca Fadda,
  • Giandomenico Maggiore,
  • Stefano Pelucchi,
  • Lucia Iannuzzi,
  • Daniela Lucidi,
  • Alberto Macchi,
  • Roberto Padoan,
  • Vincenzo Patella,
  • Giulia Dané,
  • Jan Schroeder,
  • Claudio Montuori,
  • Marco Corbò,
  • Giorgio Walter Canonica,
  • Gianenrico Senna

摘要

Purpose of Review

This review synthesizes current evidence and expert consensus on the long-term management of severe chronic rhinosinusitis with nasal polyps (CRSwNP) treated with biologics, as established by the Italian CHRONOS project.

Recent Findings

Accumulating real-world and clinical trial data confirm the sustained efficacy and safety of biologics targeting type 2 inflammation, enabling durable control and remission in a significant proportion of patients. Personalized dosing regimens, including dose-spacing strategies, appear feasible.

Summary

The CHRONOS project provides practical guidance for optimizing long-term biologic therapy in severe CRSwNP. Response assessment should combine subjective and objective measures, especially for olfactory testing. Biologics may be considered before surgery only in selected complex cases. Dose-spacing strategies may be appropriate in stable patients but require multidisciplinary oversight in those with comorbid asthma. Adverse events are uncommon. The concept of disease modification is endorsed, recognizing biologics’ potential to alter the natural history of CRSwNP.