Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: A double-blind, placebo-controlled randomized trial

Öztürk, Fadıl; Bakırtaş, Arzu; Ileri, Fikret; Türktaş, İpek

doi:10.1016/j.jaci.2011.04.045

Cited by 65 publications

(41 citation statements)

References 24 publications

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“…1429 The potential for serious side effects with systemic corticosteroid use should reserve consideration of such therapy for disease recalcitrant to more conservative measures and as a possible adjuvant to surgical therapy. Randomized prospective studies supporting nasal antihistamines or decongestants are lacking.…”

Section: Xib4 Pediatric Crs: Managementmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Xib4 Pediatric Crs: Managementmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

View full text Add to dashboard Cite

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“…After completion of therapy, both the placebo and methylprednisolone treatment groups showed significant radiographic improvement by sinus CT and clinical improvement by mean total symptom score compared with baseline scores. 17 The reduction in sinus CT scores was significantly greater with methylprednisolone compared with placebo, and complete recovery and clinically significant improvement were more frequent in the methylprednisolone group. However, given the lack of large, randomized, placebo-controlled trials, the use of topical or oral corticosteroids has not become standard of care for treatment for CRSsNP and has been implemented on a case-by-case basis by the treating physicians.…”

Section: Topical or Oral Steroidsmentioning

confidence: 83%

“…In particular, a study by Ozturk et al 17 in 2011 evaluated the potential benefit of administering oral corticosteroids and systemic antibiotics for the treatment of CRSsNP. Forty-eight children were randomized to receive either oral methylprednisolone for 15 days and amoxicillinclavanulate for 30 days or placebo for 15 days and amoxicillin-clavanulate for 30 days.…”

Section: Topical or Oral Steroidsmentioning

confidence: 99%

Chronic rhinosinusitis management beyond intranasal steroids and saline solution irrigations

Li¹,

Peters²

2015

allergy asthma proc

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“…budesonide, flunisolide, fluticasone propionate, mometasone furoate) for a 7-to 21-day period with antibiotics plus placebo (11)(12)(13)(14)(15)(16)18), whereas one compared antibiotic therapy plus an oral corticosteroid (i.e. methylprednisolone) for 30 days with antibiotic therapy plus placebo (17). All of the studies recorded a significantly greater improvement in nasal obstruction, post-nasal discharge and cough in the steroid-treated group (11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Rhinosinusitis (Rs)mentioning

confidence: 99%

“…methylprednisolone) for 30 days with antibiotic therapy plus placebo (17). All of the studies recorded a significantly greater improvement in nasal obstruction, post-nasal discharge and cough in the steroid-treated group (11)(12)(13)(14)(15)(16)(17)(18). However, although some were randomised, double-blind and placebocontrolled trials, they were clearly limited by factors such as the small number ofpatients, the inclusion of allergic children, the use of different regimens, and the absence of a microbiological evaluation (so it is not possible to determine whether the unresponsive cases were due to resistant pathogens).…”

Section: Rhinosinusitis (Rs)mentioning

confidence: 99%

Use of Topical or Systemic Steroids in Children with Upper Respiratory Tract Infection

et al. 2013

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Steroids have long been used to improve a number of clinical conditions because of their role in reducing inflammatory responses, but their use has always been limited because of their possible longterm side effects. The aim of this review is to establish whether steroids can have a positive effect on the outcome of some pediatric upper respiratory tract infections. We used PubMed to select all ofthe studies on topical or systemic steroids, and their therapeutic use in children with rhinosinusitis (RS), acute otitis media (AOM), otitis media with effusion (OME), acute pharyngitis (AP), or periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA), published over the last 15 years. Although a generally significant improvement in signs and symptoms has been observed with the use of intranasal steroids in children with RS, it is not clear which molecule should be recommended, how long treatment should be continued, or whether the benefits are limited to allergic children. No high-quality studies on the use of topical or systemic steroids in AOM have been carried out, and the results of studies of OME are controversial. The potential positive effects of steroids in children with AP are too slight to justify their use, and their possible adverse effects (particularly in the case of repeated administration) have not been clearly evaluated. Oral corticosteroids seem to be effective in resolving the symptoms of PFAPA, although they do not prevent future fever cycles. These findings show that further randomised and controlled studies are required in order to approach upper respiratory tract infections correctly and avoid the risks associated with frequent steroid use.Steroids have long been used to improve a number ofclinical conditions because oftheir role in reducing inflammatory responses (l). Inflammation is a natural host response to an infection, but an excessive response can worsen the clinical condition. Steroids act by switching off multiple inflammatory genes, such as those regulating the secretion of cytokines, chemokines, adhesion molecules and inflammatory enzymes, activating a number of anti-inflammatory genes, and increasing the degradation of the mRNA encoding certain inflammatory proteins (2).However, the use of systemic steroids has

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Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: A double-blind, placebo-controlled randomized trial

Cited by 65 publications

References 24 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Chronic rhinosinusitis management beyond intranasal steroids and saline solution irrigations

Use of Topical or Systemic Steroids in Children with Upper Respiratory Tract Infection

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