Asthma and Sinonasal Diseases: Shared Clinical Comorbidities, Inflammatory Pathways and Management Strategies

Asthma and sinonasal diseases, particularly chronic rhinosinusitis with nasal polyps (CRSwNP), frequently coexist as part of the United Airway Disease (UAD), reflecting shared inflammatory pathways and physiopathologic mechanisms. They both significantly contribute as additional comorbidities to patient burden of symptoms and disease severity, and may guide the treatment approach, particularly when presenting together. The aim of this review was to explore the clinical interplay between asthma and sinonasal diseases, emphasizing epidemiologic links, shared immunologic pathways, and emerging management strategies, namely biologic therapies targeting type 2 (T2) inflammation. This approach enables integrated diagnostic and therapeutic approaches by targeting specific inflammatory mediators in a precision-medicine perspective. This may lead to a higher chance of achieving better outcomes in both upper and lower airways. Future studies should refine the treatment selection and evaluate long-term effects of biologic therapy across the upper and lower airways.