Abstract | BACKGROUND: OBJECTIVES: SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Latest search: 25 January 2013. SELECTION CRITERIA: DATA COLLECTION AND ANALYSIS: Two authors independently assessed risk of bias in the included trial and extracted data. MAIN RESULTS: One single-centred trial (46 participants) was identified comparing a topical steroid ( betamethasone) to placebo. Twenty-two participants received the active drug.Subjective symptom scores, change in polyp size, and side effects were assessed. There was no difference in nasal symptom scores between the treatment and placebo groups. Betamethasone was effective in reducing the size of polyps, but was associated with increased reports of mild side effects, nasal bleeding and discomfort.Risk of bias was high since over 50% of people enrolled did not complete the study. Follow-up of patients was short (six weeks) also reducing the significance of the results for clinical practice. AUTHORS' CONCLUSIONS: This review suggests topical steroids for nasal polyposis in patients with cystic fibrosis have no demonstrable effect on subjective nasal symptom scores. They have some effect in reducing the size of the polyps, but due to the small sample size, poor study completion rates and lack of follow-up, the study is at high risk of bias and evidence for efficacy is limited. Overall there is no clear evidence for using topical steroids in people with cystic fibrosis and nasal polyposis.A well-designed randomised controlled trial of adequate power and long-term follow-up is needed. Validated measures of symptoms and physical findings should be performed and quality of life issues addressed.
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Authors | Helen Beer, Kevin W Southern, Andrew C Swift |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 4
Pg. CD008253
(Apr 30 2013)
ISSN: 1469-493X [Electronic] England |
PMID | 23633352
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Glucocorticoids
- Betamethasone
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Topics |
- Administration, Intranasal
- Adult
- Betamethasone
(administration & dosage, adverse effects)
- Cystic Fibrosis
(complications)
- Glucocorticoids
(administration & dosage, adverse effects)
- Humans
- Nasal Polyps
(complications, drug therapy)
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