Indication for biologic treatment in a real-world cohort of chronic rhinosinusitis patients according to international recommendations: Evidence from the European CRS outcome registry (CHRINOSOR)
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: In recent years, treatment options for patients with uncontrolled severe chronic rhinosinusitis with nasal polyps (CRSwNP) have been expanded with biologics. Definitions of uncontrolled severe disease differ across international recommendations and the prescription of biologics depends on national reimbursement criteria. Objective: We aimed to evaluate the indication for biologic treatment, based on international recommendations, in a real-world cohort of CRSwNP patients. Methods: CRS patients who visited the outpatient ENT clinic of 10 tertiary centres from 7 European countries were invited to use the Galenus Health mobile application monitoring their disease. The proportion of patients who fulfilled biologic indication criteria according to EUFOREA 2021 and EPOS/EUFOREA 2023 recommendations was evaluated. Results: A total of 281 CRS patients were recruited of which 227 (82.1%) were diagnosed as CRSwNP. Out of these 227 patients, 21 patients with prior biologic use were excluded, resulting in a cohort of 206 patients. A total of 28.7% (50/174) and 47.6% (81/170) of CRSwNP patients, met the EUFOREA 2021 or EPOS/EUFOREA 2023 criteria for indication for biologic treatment, respectively. Biologic treatment was initiated at the time of inclusion in the cohort in 18.9% (39/206) of CRSwNP patients. Conclusion: According to international recommendations, 29-48% of CRSwNP patients in tertiary centres may be a candidate for biologic treatment. EPOS/EUFOREA2023 criteria were more inclusive than EUFOREA 2021 criteria with respect to biologic indication for CRSwNP. National reimbursement criteria prevail over international recommendations for actual biologic prescription and are less restrictive in some countries.
Authors: Sven F. Seys, Josje J. Otten, Joost de Kinderen, Giulia Bettio, Alexandros Andrianakis, Isam Alobid, Carlo Cavaliere, Peter W. Hellings, Laura Van Gerven, Valérie Hox, Claire Hopkins, Anette Kjeldsen, Sven Schneider, Peter-Valentin Tomazic, Zuzana Diamant, Julia Eckl-Dorna, Wytske J. Fokkens, Clemens Holzmeister, Kenneth Larsen, Anu Laulajainen-Hongisto, Valerie Lund, Gert Mariën, Simonetta Masieri, Geoffrey Mortuaire, Mathilde Moyaert, Joaquim Mullol, Camilo Rodriguez van Strahlen, Marco de Vincentiis, Martin Wagenmann, Sietze Reitsma, Claus Bachert
Institutions: Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, Medical University of Graz, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Sapienza University of Rome, Universitair Ziekenhuis Leuven, KU Leuven, Cliniques Universitaires Saint-Luc, Guy's and St Thomas' NHS Foundation Trust, Odense University Hospital, Vienna General Hospital, Medical University of Vienna, University Medical Center Groningen, University of Groningen, Charles University, Thomayer University Hospital, University of Helsinki, Helsinki University Hospital, Eastman Dental Hospital, University College London, Centre Hospitalier Universitaire de Lille, Hôpital Claude Huriez, Düsseldorf University Hospital, Sun Yat-sen University, University of Münster, University Hospital Münster, The First Affiliated Hospital, Sun Yat-sen University
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,508
OpenAlex ID: W7140104110