The management of type 2 inflammatory respiratory diseases: a Chinese expert consensus [2024]

Type 2 (T2) inflammatory respiratory diseases encompass a range of conditions characterized by inflammation affecting the airways and lung parenchyma, with their pathogenesis rooted in T2 inflammation. Biological treatments that mitigate T2 inflammation revolutionize the therapeutic landscape for these respiratory diseases. However, there are decision-making difficulties in terms of the target population, timing of initiation, and type selection for biological targeted therapy. Search strategies were focused on relevant issues related to T2 inflammatory respiratory diseases from PubMed with search date from 2014 to 2024. The quality of evidence and grading recommendations were assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Consensus was achieved through two rounds of anonymous voting with a strong recommendation demanding at least 70% approval from the participants. A total of 370 basic research results and clinical evidence-based medical data were collected and reviewed. The latest research advances, clinical evidence, and expert insights relating to the use of biological treatments aiming at T2 inflammation in respiratory diseases and their co-morbidities were discussed rigorously and iteratively by an expert panel, and a consensus report with recommendations is presented. This consensus outlines the pathogenesis, assessment of T2 inflammation, biological therapies targeted at T2 inflammation, and management strategies for T2 inflammatory respiratory diseases and their comorbidities. It will serve as a valuable guide for clinicians in China, empowering them to diagnose and manage these conditions more effectively.