A Randomized Controlled Trial of Mometasone Furoate Nasal Spray for the Treatment of Nasal Polyposis

Stjärne, Pär; Mösges, Ralph; Jorissen, Mark; Passàli, Desiderio; Bellussi, Luisa; Staudinger, Heribert; Danzig, Melvyn R.

doi:10.1001/archotol.132.2.179

Cited by 107 publications

(148 citation statements)

References 27 publications

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“…105 In that trial, mometasone furoate 200 µg once or twice daily produced greater reductions in polyp grade at endpoint compared with placebo, with differences reaching statistical significance for twice daily dosing (p=0.04). Both regimens achieved statistically superior improvements from baseline in congestion and/or obstruction score vs placebo by the end of the first month.…”

Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 91%

“…[102][103][104][105][106][107] In 183 patients with moderate-sized nasal polyps causing clinically significant symptoms, budesonide aqueous nasal spray at a dose of 128 µg once or twice daily, or 256 µg once daily for eight weeks significantly reduced polyp size (p<0.01) and improved peak nasal inspiratory flow (p<0.001) compared with placebo. 106 Combined and individual symptom scores (blocked nose, runny nose, and sneezing) and sense of smell also improved significantly in all budesonide-treated groups.…”

Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 99%

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Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems.In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators -and therefore nasal congestion and other symptoms -should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

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Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 91%

Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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“…Several randomized clinical trials have shown these medications to be effective treatments for NP (table 1) [8,13,64,65,66,67,68,69,70,71,72,73,74,75,76]. There are few or no randomized, controlled published trials that evaluate the effectiveness of the INSs flunisolide, triamcinolone, or beclomethasone in polyposis [77].…”

Section: Resultsmentioning

confidence: 99%

Evidence-Based Management of Nasal Polyposis by Intranasal Corticosteroids: From the Cause to the Clinic

Bachert¹

2011

Int Arch Allergy Immunol

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Background: Nasal polyposis is an inflammatory disorder involving the mucosa of the nose and paranasal sinuses and affecting approximately 2–4% of the general population. Methods: A literature search of Medline and Embase was conducted to obtain an overview of the epidemiology, pathophysiology, and current treatment of nasal polyposis, focusing on evidence-based efficacy of intranasal corticosteroids (INSs) as primary and postoperative therapy. Recent research on INSs in nasal polyp treatment, along with notable historic findings, was reviewed. Results: Nasal polyps are mostly characterized by eosinophil infiltration, a complex inflammation of nasal mucosa, and possibly production of polyclonal IgE. Current treatment modalities include INSs, oral corticosteroids, and surgery; surgery is generally limited to those with an insufficient response to medical treatment. Because of their effects on eosinophil-dominated inflammation, INSs and oral corticosteroids are the primary medical treatment strategies. The very low (≤1%) systemic bioavailability of newer INSs minimizes the systemic adverse effects seen with oral corticosteroids. Conclusion:Based on randomized, controlled trials, guidelines recommend INSs as first-line therapy for nasal polyps and for care after polypectomy. Clinical data suggest INSs are effective in reducing polyp size and relieving nasal symptoms. INS treatment has also reduced nasal polyp recurrence in patients undergoing functional endoscopic sinus surgery. Treatment with these mainstay options has been found to improve quality of life, which, along with symptom improvement, is a key factor in disease treatment.

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“…1b) for 5 days, then twice daily until the bottle runs out Maintenance therapy with fluticasone (drops, spray) or mometasone (spray) is recommended as these have lower bioavailability, unlike betamethasone nasal drops [83][84][85][86].…”

Section: Text Box 4: Medical Polypectomymentioning

confidence: 99%

BSACI guidelines for the management of rhinosinusitis and nasal polyposis

Scadding

Durham

Mirakian

et al. 2007

Clin Experimental Allergy

199

222

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SummaryThis guidance for the management of patients with rhinosinusitis and nasal polyposis has been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). The recommendations are based on evidence and expert opinion and are evidence graded. These guidelines are for the benefit of both adult physicians and paediatricians treating allergic conditions. Rhinosinusitis implies inflammation of the nose and sinuses which may or may not have an infective component and includes nasal polyposis. Acute rhinosinusitis lasts up to 12 weeks and resolves completely. Chronic rhinosinusitis persists over 12 weeks and may involve acute exacerbations. Rhinosinusitis is common, affecting around 15% of the population and causes significant reduction in quality of life. The diagnosis is based largely on symptoms with confirmation by nasendoscopy. Computerized tomography scans and magnetic resonance imaging are abnormal in approximately one third of the population so are not recommended for routine diagnosis but should be reserved for those with acute complications, diagnostic uncertainty or failed medical therapy. Underlying conditions such as immune deficiency, Wegener's granulomatosis, Churg-Strauss syndrome, aspirin hypersensitivity and allergic fungal sinusitis may present as rhinosinusitis. There are few good quality trials in this area but the available evidence suggests that treatment is primarily medical, involving douching, corticosteroids, antibiotics, anti-leukotrienes, and anti-histamines. Endoscopic sinus surgery should be considered for complications, anatomical variations causing local obstruction, allergic fungal disease or patients who remain very symptomatic despite medical treatment. Further well conducted trials in clearly defined patient groups are needed to improve management.

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A Randomized Controlled Trial of Mometasone Furoate Nasal Spray for the Treatment of Nasal Polyposis

Abstract: Objective: To evaluate the efficacy and safety of mometasone furoate nasal spray (NS) for the treatment of nasal polyposis.

Cited by 107 publications

References 27 publications

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Evidence-Based Management of Nasal Polyposis by Intranasal Corticosteroids: From the Cause to the Clinic

BSACI guidelines for the management of rhinosinusitis and nasal polyposis

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