xRead - Nasal Obstruction (September 2024) Full Articles

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298

International consensus statement on rhinosinusitis

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TABLE VII-11 Evidence for intranasal corticosteroids in ARS Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions vanLoon 431 2013 1 Systematic review (n = 539) INCS review in RARS Time to clinical cure (duration of symptoms) INCS not recommended as monotherapy in RARS Zalmanovici 416 2013 1 Analysis of 4 RCTs (n = 1943) INCS Placebo Resolution of symptoms, adverse events, rates of relapse, etc. INCS improved resolution of symptoms; higher doses may have stronger effect Hayward 432 2012 1 Systematic review (n = 2495) ARS patients Symptom improvement, adverse events, relapse rates, etc. Small symptomatic benefit in ARS; higher effect with longer duration and higher doses. NNT = 13 Meltzer 433 2008 1 Systematic review Symptom

minimal-symptom days and

more minimal congestion days

ARS patients INCS useful as adjunct or as monotherapy to reduce symptoms Keith 424 2012 2 RCT(n = 737) Fluticasone 110 μ gBID(n = 240) Fluticasone 110 μ gdaily (n = 252) improvement

Placebo spray (n = 245) Both doses of INCS reduced symptoms and shortened duration of symptoms. Meltzer 423 2012 2 RCT(n = 981) Mometasone 200 μ gBID (n = 235) + placebo antibiotic Mometasone 200 μ gdaily Minimal-symptom days and

High dose INCS had more

minimal-congestion days

Amoxicillin 500 mg TID (n = 251) + placebo spray Placebo spray + placebo antibiotic (n = 252)

(n = 243) + placebo antibiotic