xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

TABLE X-27 Evidence for CRSwNP management with anti-leukotriene therapy Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Smith 1648 2014 1 Systematic review of English-language RCTs CRSwNP Symptom improvement; Other clinical parameters Moderate evidence for montelukast improving symptoms as an adjunct to INCS Wentzel 1647 2013 1 Systematic review and meta-analysis of RCTs CRSwNP Symptom improvement; Other clinical parameters Montelukast shows improvement in symptoms over placebo, similar to that seen with INCS Stryjewska Makuch 1658 2019 2 Randomized, postoperative open-label trial of INCS or montelukast or INCS + montelukast AERD Postoperative changes in symptom scores Smell tests LKscore All 3 arms showed comparable efficacy, with efficacy of montelukast similar to that seen with INCS. VanGerven 1657 2018 2 Randomized, postoperative The addition of

montelukast to INCS

did not significantly

improve any outcomes at 3, 6, and 12 months post-operatively.

Montelukast improved SNOT-20 and endoscopy scores

postoperatively in

eCRSwNP patients,

and endoscopy scores for AFS patients. No significant

improvement for

AERD patients.

improved PFTs as well as nasal symptoms andPNIF

Zileuton resulted in

open-label trial of INCS or INCS + montelukast CRSwNP Postoperative changes in symptoms TPS LMKscore AERD PFTs;

SNOT-20

LK endoscopy scores

Symptom scores PNIF

CRSwNP patients, 8 AERD, and 15 AFS

27 eosinopphilic

Yelverton 1659 2016 4 Retrospective review of all CRS patients who were prescribed montelukast

postoperatively and

then had a lapse in therapy.

Dahlen 1656 1998 2 DBRCT using zileuton 600mgQID