A short course of oral prednisone followed by intranasal budesonide is an effective treatment of severe nasal polyps.

Abstract

BACKGROUND:

Nasal polyposis is an inflammatory disease of unknown etiology. This study aimed to evaluate the effect of a short course of oral prednisone followed by intranasal budesonide on nasal symptoms, polyp size, nasal flow, and computed tomography scan.

METHODS:

Eighty-four patients with severe nasal polyps were included. After a steroid washout period, patients were randomized into two groups: group A (n = 63) received oral prednisone for 2 weeks and group B (n = 21) did not receive any steroid treatment. Patients from group A received intranasal budesonide for 12 weeks.

RESULTS:

Atopy was positive in 36.8% of patients. Blood eosinophilia was higher in asthmatic (7.2 +/- 0.7%, P < .05) than in nonasthmatic (3.0 +/- 0.4%) patients. Asthmatic patients showed higher scores on nasal obstruction and loss of smell than nonasthmatics. Oral steroids caused a significant improvement in all nasal symptoms and improved polyp size (2.1 +/- 0.1, P < .05) and nasal flow (560 +/- 35 cm/s, P < .05) compared with nontreated patients (2.8 +/- 0.1 and 270 +/- 34 cm/s, respectively). Intranasal budesonide maintained the improvement on nasal symptoms, polyp size, and nasal flow. Steroid treatment reduced the computed tomography scan score (15.4 +/- 1, P < .05) compared with before treatment (18.2 +/- 0.8).

CONCLUSION:

A short course of oral steroids improved all nasal symptoms, polyp size, and nasal flow, whereas intranasal steroid maintain this effect.

• Authors: Pedro Benítez, Isam Alobid, Josep de Haro, Joan Berenguer, Manuel Bernal-Sprekelsen, Laura Pujols, Cesar Picado, Joaquim Mullol
• Journal: The Laryngoscope (Laryngoscope) Vol. 116 Issue 5 Pg. 770-5 (May 2006) ISSN: 0023-852X [Print] United States
• PMID: 16652085 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Budesonide
• Prednisone

Topics

• Administration, Intranasal
• Administration, Oral
• Adult
• Aged
• Aged, 80 and over
• Budesonide (administration & dosage)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Nasal Polyps (diagnosis, drug therapy)
• Prednisone (administration & dosage)
• Probability
• Prospective Studies
• Reference Values
• Risk Assessment
• Severity of Illness Index
• Treatment Outcome