International Rhinologic Society Rhinology 0300-0729 2026 04 10 Reconsidering biologic treatment recommendations for CRSwNP without asthma in EUFOREA guidelines EN J. Oppenheimer Department of Internal Medicine, University of Medicine and Dentistry of New Jersey/Rutgers New Jersey Medical School, Newark, NJ, USA G.W. CanonicaPersonalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milan, Italy Department of Biomedical Sciences, Humanitas University, Milan, Italy P. Chanez Department of Respiratory Diseases, Aix-Marseille University, Marseille, France J. Maza-SolanoRhinology and Skull Base Unit, Department of Otolaryngology, University Hospital Virgen del Rocío, Seville, Spain Department of Surgery, University of Seville, Seville, Spain C. Tacon Global Medical Affairs, GSK, London, UK K. Kallinikou Respiratory Biologics, GSK, Athens, Greece P. Howarth Global Medical Affairs, GSK, London, UK M. BoniniDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy National Heart and Lung Institute (NHLI), Imperial College London, London, UK I. Eguiluz-Gracia Allergy Unit. Hospital Regional Universitario de Malaga and IBIMA-Plataforma BIONAND. RICROS Inflammatory Diseases. Malaga, Spain A. Bourdin Department of Respiratory Diseases, PhyMedExp, University of Montpellier, INSERM CNRS, Montpellier, France Letter 3445 10.4193/Rhin25.359 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 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. 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.