Efficacy of Systemic Steroid Treatment in Sinonasal Polyposis

Exosomes mediate interepithelial transfer of functional P‐glycoprotein in chronic rhinosinusitis with nasal polyps

“…A recent DBRCT demonstrated that direct inhibition of P‐gp using Verapamil hydrochloride in patients with CRSwNP led to a significant 28‐point reduction in the 22‐item Sinonasal Outcome Test, as well improvements in radiologic (i.e., Lund‐Mackay) and endoscopic (i.e., Lund‐Kennedy) scores . Because these improvements were commensurate with those reported in oral steroid and biologic therapies, elaboration of the mechanisms of P‐gp overexpression could yield deeper insights into the immunopathophysiology of CRSwNP, and thus lead to novel upstream therapeutic strategies targeting P‐gp expression and exosome trafficking.…”

Effect of steroids for nasal polyposis surgery: A placebo‐controlled, randomized, double‐blind study

“…The combination of topical and oral steroids improves conduction of odorants to the olfactory epithelium . Additionally, the use of radiofrequency for inferior turbinate in combination intranasal steroid treatment improved nasal cross‐sectional area in conjunction with discrimination and total score values for olfaction . The CCCRC test is a quantitative olfaction test.…”

“…20 Additionally, the use of radiofrequency for inferior turbinate in combination intranasal steroid treatment improved nasal cross-sectional area in conjunction with discrimination and total score values for olfaction. 21 The CCCRC test is a quantitative olfaction test. Quantitative olfaction tests are used for monitoring hyposmia patients.…”

P‐glycoprotein and chronic rhinosinusitis

“… 69 This study reported a significant effect size, comparable to previously reported values using both biologic agents and corticosteroids, with no significant side effects. 70 , 71 , 72 However, patients with elevated BMI and high total mucus P-gp levels experienced less benefit. This suggests that a low dose of a relatively low potency inhibitor was used and that patients with greater P-gp expression may need higher concentrations to achieve adequate pump suppression.…”