Blog | Friday, August 10, 2012

QD: News Every Day--No corticosteroids for acute rhinosinusitis

Systemic corticosteroid monotherapy had no clinically relevant benefit for patients with clinically diagnosed acute rhinosinusitis, a study found.

Researchers conducted a block-randomized, double-blind, placebo-controlled clinical trial at 54 primary care practices (68 family physicians) in the Netherlands from Dec. 30, 2008 through April 28, 2011. Adult patients with clinically diagnosed acute rhinosinusitis were randomly assigned to receive either prednisolone 30 mg/d or placebo for seven days and asked to complete a symptom diary for 14 days.

Results appeared at CMAJ on Aug. 7.

There were 174 patients (88 in the treatment group, 86 in the placebo group). The proportions of patients with resolution of facial pain or pressure on day 7 were 62.5% (55/88) in the prednisolone group and 55.8% (48/86) in the placebo group (absolute risk difference 6.7%, 95% confidence interval -7.9% to 21.2%).

The groups were similar for decrease in the proportion of patients with symptoms (combined symptoms of runny nose, postnasal discharge, nasal congestion, cough and facial pain) and health-related quality of life. Adverse events were mild and did not differ significantly between the groups.

While research may eventually show that some subpopulations with acute rhinosinusitis may benefit, researchers concluded, "We feel that there is no rationale for the use of corticosteroids in the broad population of patients with clinically diagnosed acute rhinosinusitis and instead advocate symptomatic treatment."