Different types of intranasal steroids for chronic rhinosinusitis

Chong, Lee Yee; Head, Karen; Hopkins, Claire; Philpott, Carl; Burton, Martin J; Schilder, Anne G. M.

doi:10.1002/14651858.cd011993.pub2

Cited by 82 publications

(59 citation statements)

References 58 publications

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“…Also, intranasal flunisolide, a topical corticosteroid, significantly affected nasal symptoms in patients with non-allergic rhinitis [123]. Flunisolide is also indicated in chronic rhinosinusitis as it is effective and has an optimal quality/cost ratio [124]. However, the nasal device and the excipients are relevant factors for improving the prolonged efficacy, safety, preference, and compliance as demonstrated for mometasone furoate nasal spray [125].…”

Section: Therapeutic Strategies For Ua Diseases Based On Local and Rementioning

confidence: 99%

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Varricchio¹,

Mantia

Brunese³

et al. 2020

Ital J Pediatr

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The upper airways (UA) should be considered as a functional unit. Current functional anatomy divides URT in three, mutually dependent, "junction boxes": i) the ostio-meatal complex (OMC), ii) the spheno-ethmoidal recess (SER), and iii) the rhinopharynx (RP). Correct ventilation and effective mucociliary clearance of these sites significantly affect the healthy physiology of the entire respiratory system. The OMC, SER, and RP obstruction is the first pathogenic step in the inflammatory/infectious cascade of UA disorders. The inflammation of the respiratory mucosa is the main pathogenic factor for airway obstruction. Moreover, bacterial biofilm (a strategy modality of bacterial survival) is an important local cause of systemic antibiotic ineffectiveness, recurrent infections, and antibiotic resistance. Health microbiota guarantees UA wellness; on the contrary, dysbiosis promotes and worsens UA infections. Allergy, namely type 2 inflammation, is a common cause of UA obstruction such as promoting in turn infections. Fiberoptic endoscopy is a mandatory diagnostic tool in clinical practice. Nasal cytology, mainly concerning flow cytometry, allows defining rhinitis phenotypes so allowing a precision medicine approach. Several conventional therapeutic approaches are available, but efficacy and safety should be ever properly considered before the prescription. Also, complementary medicine plays a fruitful role in the management of UA diseases. National and real-world studies are reported and discussed as they may be useful in daily clinical practice.

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Section: Therapeutic Strategies For Ua Diseases Based On Local and Rementioning

confidence: 99%

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Varricchio¹,

Mantia

Brunese³

et al. 2020

Ital J Pediatr

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“…There are no NICE guidelines, and although international guidelines exist, 1,5 familiarity and uptake of them is not quantified. These guidelines recommend both intranasal corticosteroids (INCS) and saline irrigation/nasal douching (ND), for which there are strong recommendations for use, based on recent Cochrane reviews [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Current use of baseline medical treatment in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)

Philpott

Erskine

Smith

et al. 2017

Clinical Otolaryngology

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The current use of baseline medical therapy in CRS appears to be very low, representing a combination of poor patient compliance, possible ineffectiveness of treatment and a lack of familiarity with current guidelines amongst general practitioners and some ENT specialists. Work is needed to disseminate guidelines to all practitioners involved and reduce unnecessary burden on existing healthcare resources for this common condition by ensuring timely referral and definitive management.

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“…The Cochrane Collaboration has recently updated a few of the published systematic reviews included in this study [6–8, 10, 20] . For completeness, full-text articles of these updated reviews and any trials not previously reviewed were analysed.…”

Section: Discussionmentioning

confidence: 99%

Developing a core outcome set for chronic rhinosinusitis: a systematic review of outcomes utilised in the current literature

Soni-Jaiswal

Lakhani

Hopkins

2017

Trials

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BackgroundA core outcome set (COS) is an agreed standardised collection of outcomes that should be measured and reported by all trials for a specific clinical area, in this case chronic rhinosinusitis. These are not restrictive and researchers may continue to explore other outcomes alongside these that they feel are relevant to their intervention. The aim of this systematic review was to identify the need for a COS for chronic rhinosinusitis.MethodsA sensitive search strategy was used to identify all published Cochrane systematic reviews and randomised control trials of intervention for adult patients with chronic rhinosinusitis. Two independent authors reviewed these to obtain a list of outcomes and outcome measures reported by each clinical trial.ResultsSixty-nine randomised control trials and eight Cochrane systematic reviews were included in this study. They reported 68 individual outcomes and outcome measures, with an average of four to ten outcomes per clinical trial. These outcomes were mapped to 23 subcategories belonging to eight core categories.ConclusionsThe key finding of this review was the heterogeneity of outcomes reported and measured by clinical trials of patients with chronic rhinosinusitis, precluding meaningful meta-analysis of data. This review supports the need for development of a COS, to be used in future trials on adult patients with chronic rhinosinusitis.

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Different types of intranasal steroids for chronic rhinosinusitis

Cited by 82 publications

References 58 publications

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Inflammation, infection, and allergy of upper airways: new insights from national and real-world studies

Current use of baseline medical treatment in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)

Developing a core outcome set for chronic rhinosinusitis: a systematic review of outcomes utilised in the current literature

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