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Acta Otorrinolaringológica Española Advances in the management of chronic rhinosinusitis with nasal polyps. Review o...
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Vol. 77. Issue 3.
(May - June 2026)
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Vol. 77. Issue 3.
(May - June 2026)
Special article

Advances in the management of chronic rhinosinusitis with nasal polyps. Review of multidisciplinary strategies and innovations in biological treatments

Avances en el manejo de la rinosinusitis crónica con pólipos nasales. Revisión de estrategias multidisciplinares e innovaciones en tratamientos biológicos
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Isam Alobida,
Corresponding author
isamalobid@gmail.com

Corresponding author.
, Alfonso del Cuvillob, Joaquim Mullola, Serafín Sánchez-Gómezc
a Unidad de Rinología, Servicio de Otorrinolaringología, Hospital Clínic, IDIBAPS, CIBERES, Universitat de Barcelona, Spain
b Unidad de Rinología y Asma, UGC ORL, Hospital Universitario de Jerez, Spain
c Unidad de Rinología y Base de Cráneo Anterior, Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
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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.

Keywords:
Biologics
Endoscopic sinus surgery
Nasal polyposis
Chronic rhinosinusitis
Resumen

La rinosinusitis crónica con pólipos nasales (RSCcPN) es una enfermedad inflamatoria crónica de las vías respiratorias superiores, caracterizada por inflamación tipo 2 (T2) y frecuentemente asociada a comorbilidades respiratorias como asma, rinitis alérgica y enfermedad respiratoria exacerbada por AINEs (EREA). Su manejo ha evolucionado desde un enfoque sintomático del tratamiento médico-quirúrgico hacia la medicina de precisión y personalizada, basada en el conocimiento a nivel molecular de los endotipos inflamatorios. Las terapias biológicas han demostrado eficacia en enfermedad grave no controlada, tanto nasosinusal como bronquial, y actualmente están disponibles en el sistema sanitario español.

No obstante, persisten desafíos clave: la falta de biomarcadores clínicos validados, la incertidumbre sobre la duración óptima del tratamiento, su combinación con la cirugía nasosinusal y el alto coste de las terapias biológicas. En este contexto, la integración de la ciencia de datos y tecnologías Big Data en el sistema sanitario español representa una oportunidad estratégica para generar evidencia real, mejorar la toma de decisiones clínicas y avanzar hacia una medicina de precisión más equitativa, eficiente y sostenible.

Palabras clave:
Biológicos
Cirugía endoscópica nasosinusal
Poliposis nasal
Rinosinusitis crónica

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