Reconsidering biologic treatment recommendations for CRSwNP without asthma in EUFOREA guidelines

The recently published EUFOREA pocket guide "Biologics in Upper and Lower Airway Diseases" summarises recommendati-ons on the use of biologics in chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma (1) and offers advice on biologic choice for practicing clinicians. The creation of this pocket guide, in the absence of any head-to-head studies at that time, drew on expert opinions and published indirect treatment compari-son (ITC) approaches (2,3). It makes a single recommendation for a preferred biologic, in patients affected by CRSwNP, without concomitant asthma (apart from specific cases such as pregnan-cy), whilst offering different options in asthma endotypes and phenotypes. We wish to draw the attention of the readership to some additional considerations relating to biologic choice for these diseases and how they are classified.