xRead - Olfactory Disorders (September 2023)

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PATEL et al.

TABLE IX-4 Evidence for CRSwNP-related olfactory loss management with intranasal topical corticosteroid therapy

Clinical end point

Study

Year 2020

LOE Study design Study groups

Conclusions Compared with

VAS (0–10) Data collection points: week 1

Xu

2

RCT

CRSwNP (N = 127) Oral methylprednisolone 24 mg once daily + budesonide NS 256 μ g once daily (n = 44) Budesonide nasal drops 1 mg once daily and budesonide NS 256 μ g once daily (n = 41) Budesonide NS 256 μ g once daily (n = 42) CRSwNP and CRSsNP (N = 187) FPNS200 μ g once daily Clarithromycin 250 mg oncedaily

et al 1386

baseline, all groups demonstrated improvement

No significant difference in

posttreatment VAS score between groups

Zeng

2019

2

RCT

VAS (0–10) Data collection

Compared with

et al 1387

baseline, both the FPand clarithromycin groups demonstrated significant improvement in VASbut no significant difference between groups placebo, only the MF NS twice-daily dosing group demonstrated significantly greater improvement at month 1 and month 4 placebo, the MF NS group demonstrated significantly greater improvement in subjective symptom score at all time points

points: month 1, month 3, month 6,month12

Khan

Compared with

Subjective

2019

2

RCT

CRSwNP (N = 310) MFNS200 μ g once daily MFNS200 μ g twice daily Placebo

et al 1388

symptom score (0–3) points: month 1 andmonth4

Data collection

Zhou

2016

2

RCT

CRSwNP (N = 748) MFNS200 μ g twice daily (n = 375) Placebo (n = 373)

Subjective

Compared with

et al 1389

symptom score (0–3)

Daily diary Data collection

points: week 4, week 8, week 12, week 16

Chong

The quality of the evidence was

Subjective

RCTs (n = 18) RCTs of CRSwNP (n = 14) Analysis including dose, frequency, and agent evaluating olfaction in CRSwNPwas identified and systematically reviewed A total of 28 RCTs

2016

1

Systematic reviewof RCTs

et al 1390

measures of olfaction

moderate for sense of smell

Bangwala et al 184

2014

1

Systematic

Subjective olfactory outcomes Objective olfactory outcomes

The results of this meta-analysis

reviewand meta-analysis

demonstrated that oral and topical steroids significantly improve olfaction in patients with CRSwNP (Continues)