xRead - Nasal Obstruction (September 2024) Full Articles

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501

Orlandi et al.

improvement in polyp size, NPIF,

inflammatory markers, nasal congestion,

post-nasal drip, and loss of smell. Return to

baseline at the end of the study.

Greater improvement of nasal symptoms, nasal

specific RSOM scores, MRI, and nasal

endoscopy in steroid arm.

Significant improvement in nasal symptoms, in polyp size and nasal patency at week. Significant

improvement

maintained for all 3

endpoints and in CT scores.

Improvement in most parameters with

steroids. Some benefits remained, up to 28 weeks. Transient

adrenal suppression

seen. Transient decrease

in markers of osteoblast

activity at 2 weeks, with return to baseline at 10 and 28 weeks.

Steroid arm showed

protocol Clinical Endpoint Conclusions

Nasal polyps grade by nasal endoscopy NPIF

Serum eosinophil count Nasal secretion of IL-5, IgE, MMP-9, ECP

Nasal symptoms score Polyp size (Lildholdt score)

Nasal patency via anterior rhinomanometry Sinus opacification (Lund-Mackay)

Endoscopic grading of polyp size Hyposmia VAS

Nasal symptoms

Nasal symptoms (VAS) RSOM-31 MRI

Nasal Endoscopy

Pocket Smell Test

Total nasal symptom score RQLQ PNIF EDN CRP

Adrenal suppression Bone Turnover

Intranasal budesonide 400 μ gBIDfor 12 weeks.

Methylprednisolone 32 mg x 5 days, 16 mg x 5 days,

8 mg x 10 days

Prednisolone 50 mg daily

Prednisolone 25 mg/d x 14days

Prednisone 30 mg daily for 4 days then decrease dose by 5 mg every 2 days.

Systemic steroid

Oral steroid for 20days

Oral doxycycline for 20days Placebo

Oral steroids x 14 days Placebo

Oral steroid x 14 days followed by intranasal fluticasone

Placebo x 14 days followed by intranasal

fluticasone

Benitez 1620 2006 2 RCT Nasal endoscopic examination N = 84 Oral prednisone x 14 days plus intranasal budesonide

No steroids

CRSwNP Study Group(s) N = 60

polyps on nasal endoscopy N = 41

“massive” nasal polypsN = 47

Presence recurrent nasal polyps after surgeryor

Definition of

VanZele 1619 2010 2 RCT, double blind,

multicenter

Hissaria 1621 2006 2 RCT, double blind Visualization of

Vaidyanathan 1618 2011 2 RCT, double blind EPOS 2007

Study Year LOE Study Design

TABLE X-21 (Continued)