xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

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TABLE X-29 Evidence for CRSwNP with AERD management with aspirin desensitization Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Larivee 1690 2020 1 SR 24 studies (RCTs, case-control, cohort) and 1272 patients undergoing desensitization SNOT-20/SNOT-22, symptom scores, oral corticosteroid use, revision surgery rates, polyp scores 23/24 studies recommended desensitization based on improved symptoms, decreased steroid use, improved revision surgery rate, improved polyp size and recurrence Chu 1689 2019 1 SR with meta-analysis 5 RCTs including 233 patients Symptom scores, QoL, adverse events Moderate and high certainty evidence supports improved symptoms and QoL, but increased rates of adverse events Mortazavi 1686 2017 2 RCT, placebo controlled 22 patients undergoing desensitization vs 19 in placebo group SNOT-22, Lund-Mackay score, medication scores, FEV1, IL-4, IL-5 Significant improvement in SNOT-22, medication scores, FEV1 and IL-5 at 6 months. No improvement in Lund-Mackay scores. Esmaeilzadeh 1685 2015 2 RCT, placebo controlled 18 patients undergoing desensitization vs 16 in placebo group Symptom scores (SNOT-22), medication scores, Lund-Mackay scores, FEV1, adverse events Improved symptom scores, medication scores, Lund-Mackay scores, FEV1 at 6 months in treatment group. 1 patient discontinued therapy due to severe GI bleed, 1 due to skin rash. Swierczynska Krepa 1367 2014 2 RCT, placebo controlled 12 patients undergoing desensitization vs 8 in placebo group Symptom scores (including ACQ, SNOT-22), inhaled corticosteroid use, adverse events Significant improvement in symptom scores and inhaled corticosteroid use compared to placebo. 5 patients discontinued therapy due to adverse gastrointestinal events (dyspepsia).