Low Dose, Short-Term Oral Methylprednisolone for Nasal Polyps: A Randomized Double-Blind Placebo-Controlled Trial
Keywords:Nasal polyposis, methylprednisolone, rhinorrhea, nasal congestion, anosmia
Objectives: To determine the efficacy of a 7-day treatment of methylprednisolone 16mg in
reducing the size of nasal polyps and on improvement of nasal symptoms.
Design: Randomized double-blind placebo-controlled trial
Setting: Out-patient department of the East Avenue Medical Center
Patients: Patients 18 years old and above with nasal polyposis determined by history and endoscopic examination
Results: There was a significant decrease in polyp size by an average of 16% (P < .05) among 12 out of the 23 patients (52.17 %) in the steroid group versus placebo. The treatment group also exhibited an improvement in nasal symptoms of rhinorrhea, congestion and anosmia compared to the placebo.
Conclusion: Medical treatment with oral methylprednisolone given at a low dose of 16 mg for one week resulted in reduction of the size of nasal polyps and improved the symptoms of rhinorrhea, nasal congestion and anosmia. Other associated symptoms like headache, epistaxis, sneezing, itchiness, epiphora, cough, postnasal drip, throat discomfort, facial pain, eye complaints and fever did not differ between the steroid and placebo groups.
Recommendation: One week of oral steroids can be used to treat nasal polyps initially. If there is response, this mode of management can be combined with a long-term course of intranasal steroid sprays9,10. Patients who do not respond may be referred for surgery.
Keywords: Nasal polyposis, methylprednisolone, rhinorrhea, nasal congestion, anosmia
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