Where Are We in the Medical Treatment of CRS with Nasal Polyps/Eosinophilic Chronic Rhinosinusitis

In the revised EPOS2020 classification of CRS (Fokkens et al., Rhinology 2020(Supplement 29):1–464, 2020), chronic rhinosinusitis with nasal polyps (CRSwNP) is a phenotypic example of a Type 2 endotype. It is also associated with a range of co-morbidities that require diagnosis and treatment, ideally in a multi-disciplinary setting. This classification explains why the most effective medications are corticosteroids and more recently a range of biologics which target specific points in the Type 2 inflammatory cascade. An increasing number of randomised controlled trials (RCTs) now support our ‘best clinical practice’ summarised in an integrated care pathway and facilitating individualised/personalised care. However, to achieve optimum control, both long-term medication together with surgery are often required, underpinned by education of patients and care-givers.