Impact of topical nasal steroid therapy on symptoms of nasal polyposis: A Meta-Analysis

Luke Rudmik, Rodney J. Schlosser, Timothy Smith, Zachary M. Soler

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objectives/Hypothesis: Topical steroid therapy is an important strategy in the management of chronic rhinosinusitis (CRS) with nasal polyposis. The objective of this study was to determine the impact of topical steroid therapy on nasal symptoms in patients with nasal polyposis. Study Design: Systematic review with meta-analysis using standardized methodology. Methods: Study inclusion criteria included: randomized, placebo controlled trials, nasal polyposis, and topical steroid therapy. Exclusion criteria included: failure to report at least one symptom-based outcome measure, concurrent use of systemic steroids, or mixed CRS cohorts (polyp and nonpolyp patients). Quantitative analysis was performed using a random effect model. The PRISMA guidelines for meta-analysis reporting were followed. Results: A total of 19 studies fulfilled eligibility. Seven studies were excluded from the meta-analysis due to significant heterogeneity in outcome reporting. A total of 12 studies were combined for quantitative analysis and demonstrated a pooled risk ratio of 1.72 (95% confidence interval, 1.41-2.09), indicating a significant improvement in nasal symptoms. All three topical steroid preparations (fluticasone, mometasone, and budesonide) resulted in symptom improvement. All seven studies excluded from the meta-analysis qualitatively confirmed the overall findings. Conclusions: Topical nasal steroid therapy improves nasal symptoms in CRS patients with nasal polyposis. Future studies will need to evaluate the impact on quality of life, preferably using validated disease-specific instruments.

Original languageEnglish (US)
Pages (from-to)1431-1437
Number of pages7
JournalLaryngoscope
Volume122
Issue number7
DOIs
StatePublished - Jul 2012

Fingerprint

Nose
Meta-Analysis
Steroids
Mometasone Furoate
Therapeutics
Budesonide
Polyps
Randomized Controlled Trials
Odds Ratio
Placebos
Quality of Life
Outcome Assessment (Health Care)
Guidelines
Confidence Intervals

Keywords

  • budesonide
  • Chronic
  • fluticasone
  • mometasone
  • polyps
  • quality of life
  • rhinosinusitis
  • sinusitis
  • symptoms
  • topical steroids

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Impact of topical nasal steroid therapy on symptoms of nasal polyposis : A Meta-Analysis. / Rudmik, Luke; Schlosser, Rodney J.; Smith, Timothy; Soler, Zachary M.

In: Laryngoscope, Vol. 122, No. 7, 07.2012, p. 1431-1437.

Research output: Contribution to journalArticle

Rudmik, Luke ; Schlosser, Rodney J. ; Smith, Timothy ; Soler, Zachary M. / Impact of topical nasal steroid therapy on symptoms of nasal polyposis : A Meta-Analysis. In: Laryngoscope. 2012 ; Vol. 122, No. 7. pp. 1431-1437.
@article{21bf70b6acef4b28a969a957a522ddac,
title = "Impact of topical nasal steroid therapy on symptoms of nasal polyposis: A Meta-Analysis",
abstract = "Objectives/Hypothesis: Topical steroid therapy is an important strategy in the management of chronic rhinosinusitis (CRS) with nasal polyposis. The objective of this study was to determine the impact of topical steroid therapy on nasal symptoms in patients with nasal polyposis. Study Design: Systematic review with meta-analysis using standardized methodology. Methods: Study inclusion criteria included: randomized, placebo controlled trials, nasal polyposis, and topical steroid therapy. Exclusion criteria included: failure to report at least one symptom-based outcome measure, concurrent use of systemic steroids, or mixed CRS cohorts (polyp and nonpolyp patients). Quantitative analysis was performed using a random effect model. The PRISMA guidelines for meta-analysis reporting were followed. Results: A total of 19 studies fulfilled eligibility. Seven studies were excluded from the meta-analysis due to significant heterogeneity in outcome reporting. A total of 12 studies were combined for quantitative analysis and demonstrated a pooled risk ratio of 1.72 (95{\%} confidence interval, 1.41-2.09), indicating a significant improvement in nasal symptoms. All three topical steroid preparations (fluticasone, mometasone, and budesonide) resulted in symptom improvement. All seven studies excluded from the meta-analysis qualitatively confirmed the overall findings. Conclusions: Topical nasal steroid therapy improves nasal symptoms in CRS patients with nasal polyposis. Future studies will need to evaluate the impact on quality of life, preferably using validated disease-specific instruments.",
keywords = "budesonide, Chronic, fluticasone, mometasone, polyps, quality of life, rhinosinusitis, sinusitis, symptoms, topical steroids",
author = "Luke Rudmik and Schlosser, {Rodney J.} and Timothy Smith and Soler, {Zachary M.}",
year = "2012",
month = "7",
doi = "10.1002/lary.23259",
language = "English (US)",
volume = "122",
pages = "1431--1437",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

TY - JOUR

T1 - Impact of topical nasal steroid therapy on symptoms of nasal polyposis

T2 - A Meta-Analysis

AU - Rudmik, Luke

AU - Schlosser, Rodney J.

AU - Smith, Timothy

AU - Soler, Zachary M.

PY - 2012/7

Y1 - 2012/7

N2 - Objectives/Hypothesis: Topical steroid therapy is an important strategy in the management of chronic rhinosinusitis (CRS) with nasal polyposis. The objective of this study was to determine the impact of topical steroid therapy on nasal symptoms in patients with nasal polyposis. Study Design: Systematic review with meta-analysis using standardized methodology. Methods: Study inclusion criteria included: randomized, placebo controlled trials, nasal polyposis, and topical steroid therapy. Exclusion criteria included: failure to report at least one symptom-based outcome measure, concurrent use of systemic steroids, or mixed CRS cohorts (polyp and nonpolyp patients). Quantitative analysis was performed using a random effect model. The PRISMA guidelines for meta-analysis reporting were followed. Results: A total of 19 studies fulfilled eligibility. Seven studies were excluded from the meta-analysis due to significant heterogeneity in outcome reporting. A total of 12 studies were combined for quantitative analysis and demonstrated a pooled risk ratio of 1.72 (95% confidence interval, 1.41-2.09), indicating a significant improvement in nasal symptoms. All three topical steroid preparations (fluticasone, mometasone, and budesonide) resulted in symptom improvement. All seven studies excluded from the meta-analysis qualitatively confirmed the overall findings. Conclusions: Topical nasal steroid therapy improves nasal symptoms in CRS patients with nasal polyposis. Future studies will need to evaluate the impact on quality of life, preferably using validated disease-specific instruments.

AB - Objectives/Hypothesis: Topical steroid therapy is an important strategy in the management of chronic rhinosinusitis (CRS) with nasal polyposis. The objective of this study was to determine the impact of topical steroid therapy on nasal symptoms in patients with nasal polyposis. Study Design: Systematic review with meta-analysis using standardized methodology. Methods: Study inclusion criteria included: randomized, placebo controlled trials, nasal polyposis, and topical steroid therapy. Exclusion criteria included: failure to report at least one symptom-based outcome measure, concurrent use of systemic steroids, or mixed CRS cohorts (polyp and nonpolyp patients). Quantitative analysis was performed using a random effect model. The PRISMA guidelines for meta-analysis reporting were followed. Results: A total of 19 studies fulfilled eligibility. Seven studies were excluded from the meta-analysis due to significant heterogeneity in outcome reporting. A total of 12 studies were combined for quantitative analysis and demonstrated a pooled risk ratio of 1.72 (95% confidence interval, 1.41-2.09), indicating a significant improvement in nasal symptoms. All three topical steroid preparations (fluticasone, mometasone, and budesonide) resulted in symptom improvement. All seven studies excluded from the meta-analysis qualitatively confirmed the overall findings. Conclusions: Topical nasal steroid therapy improves nasal symptoms in CRS patients with nasal polyposis. Future studies will need to evaluate the impact on quality of life, preferably using validated disease-specific instruments.

KW - budesonide

KW - Chronic

KW - fluticasone

KW - mometasone

KW - polyps

KW - quality of life

KW - rhinosinusitis

KW - sinusitis

KW - symptoms

KW - topical steroids

UR - http://www.scopus.com/inward/record.url?scp=84862836265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862836265&partnerID=8YFLogxK

U2 - 10.1002/lary.23259

DO - 10.1002/lary.23259

M3 - Article

C2 - 22410935

AN - SCOPUS:84862836265

VL - 122

SP - 1431

EP - 1437

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 7

ER -