Effect of Topical Furosemide on Rhinosinusal Polyposis Relapse After Endoscopic Sinus Surgery

Abstract

Iranian Registry of Clinical Trials registration number: IRCT201403143186N5.

International consensus statement on allergy and rhinology: rhinosinusitis 2021

“…, supplemented these findings in 2 subsequent randomized, non‐placebo controlled trials. The authors explored the efficacy of intranasal furosemide in preventing relapse of nasal polyposis for up to 6 years 1566,1662–1664 . In these studies, the experimental group was comprised of patents having undergone recent ESS that were provided furosemide post‐operatively for 1 month.…”

“…Over 13 years later a placebo‐controlled clinical trial was carried out in Iran by Hashemian et al The investigators performed a triple blind, randomized‐controlled study comparing topical furosemide to a placebo nasal spray in the setting of INCS (fluticasone) use 1664 . Prior to surgery, all patients were treated with 30 mg of prednisolone, 400 mg cefixime, and flucticasone 2 puffs twice a day for 10 days.…”

“…Neither Hashemian et al nor Passali et al 1566 reported on the prevalence of asthma or aspirin intolerance in their cohort of patients with CRSwNP. Hashemian et al did not document the type or extent of “sinus surgery,” 1664 whereas Passali et al divided procedure type into endoscopic polypectomy plus anterior ethmoidectomy (n = 95), endoscopic polypectomy plus anteroposterior ethmoidectomy (49) 1566,1663 and endoscopic polypectomy (n = 26) 1566 . Hashemian et al demonstrated no significant difference in the grade of polyposis prior to intervention, whereas Passali et al 1566 stated that “the severity of disease before surgery was similar” in the control and intervention groups 1566,1663 .…”

Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis

“…Ten RCTs [14][15][16][17][18][19][20][21][22][23] and 42 RWE studies reported mean or median baseline SNOT-22 scores for study populations consisting of surgical candidates. In all studies, baseline SNOT-22 score was assessed prior to surgical interventions.…”

“…Five RCTs [14][15][16][17][18] and 25 RWE studies 65 reported mean baseline SNOT-22 scores in the moderate range. Five RCTs [19][20][21][22][23] and 17 RWE studies [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] reported severe mean baseline SNOT-22 scores. These findings were consistent with the treatment plan for CRSwNP provided by Fokkens et al 92 , which recommended surgery as treatment for patients with more severe symptoms or with polyps that are recalcitrant to medical management.…”