Effect of short-course glucocorticoid application on patients with chronic rhinosinusitis with nasal polyps

作者：Zhaofeng Xu, Xin Luo, Lei Xu, Jie Deng, Wenxiang Gao, Lijie Jiang, Zhaoqi Huang, Jianbo Shi, Yinyan Lai · 发表于：World Allergy Organization Journal · 年份：2020 · DOI：10.1016/j.waojou.2020.100131 · 被引用次数：31 · 研究领域：Sinusitis and nasal conditions、Allergic Rhinitis and Sensitization、Nasal Surgery and Airway Studies

Background Local and systemic glucocorticoids are mainstay therapies for chronic rhinosinusitis. With respect to local glucocorticoids, nasal spray is used extensively, but some patients do not benefit from short-course treatment. Recently, some clinicians have focused on the effects of high-dose local glucocorticoids in chronic rhinosinusitis with nasal polyps (CRSwNP), such as treatment using nasal irrigation, transnasal nebulization, and nose-dripping therapy (nasal drop) with high-dose budesonide. However, there are little data comparing the effect of short-course high-dose local glucocorticoids with regular nasal spray and oral steroids in the treatment of preoperative CRSwNP patients. Furthermore, the appropriate use of different types of glucocorticoids in different endotypes of CRSwNP remains unclear. Methods This randomized controlled clinical research study was performed at a single academic center. Patients who satisfied the criteria of chronic rhinosinusitis with bilateral nasal polyps were randomly assigned in a 1:1:1 ratio to receive oral methylprednisolone, 24 mg/d and budesonide nasal spray, 256 μg/d, or intranasal budesonide suspension, 1 mg/d and budesonide nasal spray, 256 μg/d, or budesonide nasal spray, 256 μg/d for one week. Symptoms, endoscopic scores, and tissue and blood inflammatory cells were recorded before and after the study. Adverse events were recorded by clinicians. Results A total of 127 patients with CRSwNP underwent randomization. The total...