Treatment Approach to Chronic Rhinosinusitis Based on Endotype: Difference Between East and West

Clin Exp Allergy. 2025 Nov;55(11):1052-1056. doi: 10.1111/cea.70150. Epub 2025 Oct 2.

Abstract

Heterogeneity among CRSwNP patients in Western and Eastern countries leads to differences in management. Type 2 (T2) inflammation accounts for the majority of CRSwNP patients in Western countries, while non-T2 inflammation is the main endotype in CRSwNP patients in Eastern countries. Precise identification of T2 inflammation holds significant promise for optimising treatment outcomes. The treatment of T2 inflammation-biased CRSwNP primarily involves glucocorticoids, reboot surgery, and T2 biologics, while non-T2 inflammation-dominant CRSwNP is mainly treated with macrolide antibiotics.

Publication types

  • Review
  • Editorial

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Chronic Disease
  • Humans
  • Nasal Polyps* / therapy
  • Rhinitis* / diagnosis
  • Rhinitis* / epidemiology
  • Rhinitis* / etiology
  • Rhinitis* / therapy
  • Rhinosinusitis
  • Sinusitis* / diagnosis
  • Sinusitis* / epidemiology
  • Sinusitis* / therapy

Substances

  • Anti-Bacterial Agents