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Predictors of efficacy for combination oral and topical corticosteroids to treat patients with chronic rhinosinusitis with nasal polyps

International Forum of Allergy & Rhinology Nov 08, 2019

Epperson MV, et al. - Sixty-four persons with chronic rhinosinusitis (CRS), bilateral polyps, a polyp score of at least 3, and a 22-item Sino-Nasal Outcome Test (SNOT-22) score ≥ 20 were prospectively recruited and uniformly treated with a 15-day prednisone taper and twice-daily dilute budesonide irrigations in order to recognize features that would be imminent of efficiency for this combination regimen. Pretreatment SNOT-22 score and comorbid asthma were related to an alteration in SNOT-22 experienced over the study period. Attaining a greater-than-1 minimal clinically important difference (MCID) betterment in the SNOT-22 score was also correlated with pretreatment SNOT-22 score and comorbid asthma. In order to identify individuals experiencing one MCID improvement, SNOT-22 score ≥ 47 had 81.5% and 78.4% sensitivity and specificity, respectively. The pretreatment polyp score was not related to any outcome metric. Therefore, pretreatment endoscopy was not educational about treatment response in the treatment of CRS with nasal polyps with prednisone and budesonide irrigations. Moreover, pretreatment SNOT-22 and comorbid asthma could be more predictive.
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