Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the most up-to-date management of uncontrolled upper airway inflammatory pathologies. The aim was to introduce precision medicine into the field. Starting with allergic rhinitis (AR), authors described how precision medicine could be implemented in the step-wise approach of managing allergic rhinitis. The main stay of such implementation is by educating patients and discussing options openly with them (participation), in addition to explaining the likely outcome (prediction), working towards halting the progression of the disease (prevention) and finally by tweaking treatment based on most interfering symptoms in patients who are not yet controlled (personalisation). The same approach was advised for chronic rhinosinusitis (CRS) with specific emphasis on prevention of asthma, which might be helped by FESS in CRS patients. Additionally, the importance of new monoclonal antibodies treatments for CRS was highlighted and was offered as part of personalisation in uncontrolled CRS. Authors concluded that implementing precision medicine might have significant impact on patient satisfaction. It was also pointed out that socio-economic factors should be thought of when precision medicine is applied. Finally, they emphasised the importance of further research.
Precision medicine in allergic rhinitis and chronic rhinosinusitis
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