Predictors of efficacy for combination oral and topical corticosteroids to treat patients with chronic rhinosinusitis with nasal polyps

Epperson, Madison V.; Phillips, Katie; Caradonna, David S.; Gray, Stacey T.; Sedaghat, Ahmad R.

doi:10.1002/alr.22431

Cited by 13 publications

(9 citation statements)

References 52 publications

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“…Medical regimen of interest: Twice daily budesonide irrigation (0.5 mg/2mL respule into a 240‐mL saline irrigation bottle) and a 15‐day prednisone taper (50 mg by mouth [PO] daily for 3 days, 40 mg PO daily for 3 days, 30 mg PO daily for 3 days, 20 mg PO daily for 3 days, and 10 mg PO for 3 days) 30 …”

Section: Resultsmentioning

confidence: 99%

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The predictive utility of the 22‐item sino‐nasal outcome test (SNOT‐22): A scoping review

Liu

Weitzel³

et al. 2021

Int Forum Allergy Rhinol

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Background The 22‐item sino‐nasal outcome test (SNOT‐22) is a widely used and powerful patient‐reported outcomes measure for chronic rhinosinusitis (CRS). More recently; however, the SNOT‐22 has been evaluated as a predictive tool for multiple conditions. The objective of this scoping review is to investigate the extent to which SNOT‐22 is used in this manner and present this information in a way useful for clinicians. Methods A systematic search of PubMed, Scopus, Cochrane Library, and Web of Science was performed. Studies that evaluated SNOT‐22s predictive utility were considered for eligibility in this scoping review. Results A total of 39 studies met eligibility. The SNOT‐22 was found to be used as a predictive tool in three broad categories: (1) to predict a diagnosis, (2) to predict an outcome of an intervention, and (3) to predict a patient treatment preference. Thirteen studies were included in the diagnosis category, which made up ten different individual predictions. Twenty‐four studies were included in the outcomes category and investigated 17 different individual predictions. Finally, two studies were included in the patient preferences category, which together made one prediction. Conclusions The SNOT‐22 is a versatile tool that has the potential to be used in predicting various diagnoses, outcomes, and patient preferences. However, care must be taken in applying these predictions to clinical practice, as further research must be done in validating these predictions based on SNOT‐22 responses.

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Section: Resultsmentioning

confidence: 99%

“…Adult patients (≥18 years old) with CRSwNP, bilateral polyps with polyp score of at least 3, and SNOT‐22 score ≥20 30 …”

Section: Resultsmentioning

confidence: 99%

The predictive utility of the 22‐item sino‐nasal outcome test (SNOT‐22): A scoping review

Liu

Weitzel³

et al. 2021

Int Forum Allergy Rhinol

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“…Similar results observed in other studies. [6][7][8][9][10][11] Fig. 1: The line graph shows the preoperative, postoperative (2nd week), and postoperative (6 t h week) SNOT-22 score of category A and category B.…”

Section: Discussionmentioning

confidence: 99%

A comparative study on the effectiveness of budesonide nasal irrigation versus normal saline nasal irrigation in post endoscopic sinus surgery patients

Faruq¹,

Lakshmi

Rao³

2021

IJOAS

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: Comparative studies evaluating budesonide and saline nasal irrigations for patients with polyposis/ rhinosinusitis are deficient in the current literature. This study aimed to evaluate the effectiveness of budesonide nasal irrigations compared with saline irrigations during postoperative care of patients with rhinosinusitis.: A total of 100 patients who underwent functional Endoscopic Sinus SurgeryESS) were randomly divided into two groups (A and B) of 50 participants each (normal saline [NS] + budesonide irrigation and NS irrigation alone, respectively). Pre- and post operative evaluation was done with a 22-item sinonasal outcomes test (SNOT-22), and Lund Kennedy endoscopic (LKE scores) in second and sixth week. : The condition of the patients significantly improved in both intervention arms related to SNOT-22 and LKE score at each postoperative visit (Group A: p<0.001, Group B: p<0.001). The reduction of SNOT 22 score was higher in budesonide group by 10% (mean SNOT 22 score from 33.31 to 15.84) compared to normal saline group (mean SNOT 22 score from 37.49 to 22.24). The reduction of LKEscore was higher in budesonide group by 18.69% (mean LKE score from 4.49 to 2.71) compared to normal saline group (mean LKE score from 5.02 to 4). : Steroid nasal irrigation is a good option in postoperative EES patients. The difference of reduction of both SNOT 22 score and LKEscore was statistically significant (p <0.05 and p<0.01 respectively) by repeated contrast test. This study is one of the few comparative studies evaluating budesonide and saline nasal irrigations in post-ESS patients.

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“…Budesonide nasal irrigations are a well-described medical treatment for CRSwNP. 19,20 However, to the best of our knowledge, the efficacy of budesonide irrigations has not been previously described specifically for CRSwNP in AERD. In fact, the only dedicated study of intranasal corticosteroids for CRSwNP in AERD that we are aware of is by Mastalerz et al 21 who studied the efficacy of fluticasone propionate nasal spray.…”

Section: Introductionmentioning

confidence: 99%

Chronic Rhinosinusitis Outcomes of Patients With Aspirin-Exacerbated Respiratory Disease Treated With Budesonide Irrigations: A Case Series

Talat

Gengler

Phillips

et al. 2021

Ann Otol Rhinol Laryngol

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Background: Pathophysiology-targeting treatments exist for aspirin-exacerbated respiratory disease (AERD) through aspirin desensitization and biologics, such as dupilumab. With increasing attention paid to these treatments, which may be associated with significant side effects and/or cost, there is little description of chronic rhinosinusitis with nasal polyps (CRSwNP) response to treatment with intranasal corticosteroids and saline irrigations in AERD. Objective: To determine the effect of intranasal budesonide irrigations for the treatment of CRSwNP in AERD. Methods: This is an observational study of 14 AERD patients presenting to a rhinology clinic for CRS who were treated with twice daily high volume, low pressure irrigations with 240 mL of saline to which a 0.5 mg/2 mL respule of budesonide was added. All participants completed a 22-item Sinonasal Outcome Test (SNOT-22) at enrollment and at follow up 1 to 6 months later. Polyp scores were also calculated at each time point. Results: SNOT-22 scores ranged from 26 to 98 (median: 40.5) at enrollment and 3 to 85 (median: 38.5) at follow-up. Polyp scores ranged from 2 to 6 (median: 4) at enrollment at 0 to 6 (median: 2) at follow-up. Over the treatment period, change in SNOT-22 score ranged from −38 to 16 (median: −18) and change in polyp score ranged from −2 to 0 (median: −0.5). Approximately 57% of participants experienced at least 1 minimal clinically important difference in SNOT-22 score and 21% of participants had a SNOT-22 score <20 at follow-up. Conclusion: Medical management with intranasal corticosteroids and saline irrigations alone leads to significant improvement in sinonasal symptomatology in a subset of AERD.

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Predictors of efficacy for combination oral and topical corticosteroids to treat patients with chronic rhinosinusitis with nasal polyps

Cited by 13 publications

References 52 publications

The predictive utility of the 22‐item sino‐nasal outcome test (SNOT‐22): A scoping review

The predictive utility of the 22‐item sino‐nasal outcome test (SNOT‐22): A scoping review

A comparative study on the effectiveness of budesonide nasal irrigation versus normal saline nasal irrigation in post endoscopic sinus surgery patients

Chronic Rhinosinusitis Outcomes of Patients With Aspirin-Exacerbated Respiratory Disease Treated With Budesonide Irrigations: A Case Series

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