Publication
Azitromycin for chronic eosihophilic rhinosinusitis with nasal polyp: a placebo-controlled trial
| Summary: | Background: Chronic eosinophilic rhinosinusitis with nasal polyps (CRSwNP eosinophilic) is characterised by the formation of benign and bilateral nasal polyps. We aimed to compare the effectiveness of azithromycin as an immunomodulator with the use of a placebo in patients presenting with CRSwNP concomitant with asthma and aspirin intolerance after 3 months of treatment and at a 1-year follow-up.Methodology: We performed a randomised, double-blind, placebo-controlled trial. Patients received 500 mg azithromycin orally three times/week for 12 weeks. Improvement was evaluated by staging, the Sino-Nasal Outcome Test (SNOT-22), and nasal polyp biopsy. Data collected at pretreatment and 3 months posttreatment were compared. Quality of life was evaluated at the 1-year follow-up. Results: Twenty-seven and 21 patients were treated with azithromycin and a placebo, respectively. The medication was well tolerated overall. Twenty patients (74%) in the azithromycin group and three patients (14%) in the placebo group were not referred for surgery at the end of the 3-month treatment. Regarding subjective improvement, there was a median decrease only in the azithromycin group, and the between-group difference was significant. SNOT-22 improvement was maintained in the azithromycin group at the 1-year follow-up. Conclusions: Azithromycin could be considered a therapeutic option for patients presenting with CRSwNP concomitant with asthma and aspirin intolerance. |
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| Main Authors: | Isamara Simas de Oliveira |
| Other Authors: | Alessandro Fernandes Guimarães; Gabriela Rafael Arantes Pêgas; Carla Jorge Machado; Giovanni Dantas Cassali; Paulo Crossara; Flávio Barbosa Nunes; Helena Maria Gonçalves Becker; Roberto Eustáquio Santos Guimarães |
| Subject: | Aspirin Azithromycin Endoscopy Eosinophils Nasal polyposis Aspirina Azitromicina Endoscopia Eosinófilos Pólipos Nasais |
| Year: | 2023 |
| Country: | Brazil |
| Document type: | article |
| Access type: | open access |
| Associated institution: | IBICT |
| Language: | Portuguese |
| Origin: | Oasisbr |
| Summary: | Background: Chronic eosinophilic rhinosinusitis with nasal polyps (CRSwNP eosinophilic) is characterised by the formation of benign and bilateral nasal polyps. We aimed to compare the effectiveness of azithromycin as an immunomodulator with the use of a placebo in patients presenting with CRSwNP concomitant with asthma and aspirin intolerance after 3 months of treatment and at a 1-year follow-up.Methodology: We performed a randomised, double-blind, placebo-controlled trial. Patients received 500 mg azithromycin orally three times/week for 12 weeks. Improvement was evaluated by staging, the Sino-Nasal Outcome Test (SNOT-22), and nasal polyp biopsy. Data collected at pretreatment and 3 months posttreatment were compared. Quality of life was evaluated at the 1-year follow-up. Results: Twenty-seven and 21 patients were treated with azithromycin and a placebo, respectively. The medication was well tolerated overall. Twenty patients (74%) in the azithromycin group and three patients (14%) in the placebo group were not referred for surgery at the end of the 3-month treatment. Regarding subjective improvement, there was a median decrease only in the azithromycin group, and the between-group difference was significant. SNOT-22 improvement was maintained in the azithromycin group at the 1-year follow-up. Conclusions: Azithromycin could be considered a therapeutic option for patients presenting with CRSwNP concomitant with asthma and aspirin intolerance. |
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