BACKGROUND: @entity102 ( @entity102 ) with @entity1412 is common. The long-term efficacy and safety of approaches to medical management are not well-known. OBJECTIVE: To evaluate the efficacy and safety of a 2-week regimen of oral @entity134 therapy followed by 26 weeks of sequential topical @entity134 maintenance therapy. DESIGN: Parallel randomized trial with computer-generated block randomization and central allocation. @entity1 and investigators were blinded to group assignment. (ClinicalTrials.gov registration number: NCT00788749) SETTING: A specialty rhinology clinic in Tayside, Scotland. @entity1 : 60 adults with @entity102 and moderate-sized or larger nasal @entity1127 who were referred by their primary physicians for specialty care. INTERVENTIONS: @entity1 were randomly assigned in a 1:1 ratio to receive oral @entity617 , 25 mg/d, or placebo for 2 weeks, followed in both groups by @entity5023 nasal drops, 400   g twice daily, for 8 weeks and then @entity5023 nasal spray, 200   g twice daily, for 18 weeks. MEASUREMENTS: Polyp grading (primary outcome), @entity9905 score, quality of life, symptoms, nasal patency, adrenal function, and bone turnover. RESULTS: The mean decrease in polyp grade from baseline to 2 weeks was 2.1 units (SD, 1.1) in the @entity617 group and 0.1 unit (SD, 1.0) in the placebo group (mean difference between groups, -1.8 units [95% CI, -2.4 to -1.2 units]; P < 0.001). The difference between groups was -1.08 units (CI, -1.74 to -0.42 unit; P = 0.001) at 10 weeks and -0.8 unit (CI, -1.8 to 0.2 unit; P = 0.11) at 28 weeks. The mean decrease in @entity9905 score from baseline to 2 weeks was 31.12 mm (SD, 30.1) in the @entity617 group and 1.41 mm (SD, 30.6) in the placebo group (mean difference between groups, -28.33 mm [CI, -42.71 to -13.96 mm]; P = 0.002). The difference between groups was -16.06 mm (CI, -30.99 to -1.13 mm; P = 0.03) at 10 weeks and -12.13 mm (CI, -30.55 to 6.29 mm; P = 0.19) at 28 weeks. @entity617 therapy resulted in transient suppression of adrenal function and increase in bone turnover after 2 weeks, with a return to baseline at 10 and 28 weeks. LIMITATIONS: @entity1 were referred from primary care to a single-center rhinology clinic, which limits the generalizability of results. Serial measurements of surrogates of @entity32 (such as @entity842 or cytokine levels) were not performed. CONCLUSION: Initial oral @entity134 therapy followed by topical @entity134 therapy seems to be more effective over 6 months than topical @entity134 therapy alone in decreasing polyp size and improving olfaction in @entity1 referred for specialty care of @entity102 with at least moderate @entity1412 . PRIMARY FUNDING SOURCE: Chief Scientist Office, Scotland; National Health Service Tayside Small Grants Scheme; and an Anonymous Trust grant from University of Dundee.

Treatment of chronic rhinosinusitis with XXXX with oral steroids followed by topical steroids: a randomized trial.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity32 :: ('MESH:D007249', 'Disease') :: ['nasal inflammation'] @entity1127 :: ('MESH:D011127', 'Disease') :: ['polyps'] @entity102 :: ('MESH:D002908', 'Disease') :: ['CRS', 'Chronic rhinosinusitis'] @entity134 :: ('CHEBI:35341', 'Chemical') :: ['steroid'] @entity9905 :: ('MESH:C564321', 'Disease') :: ['hyposmia'] @entity842 :: ('MESH:D009569', 'Chemical') :: ['nitric oxide'] @entity1412 :: ('MESH:D011125', 'Disease') :: ['nasal polyposis'] @entity5023 :: ('MESH:C065382', 'Chemical') :: ['fluticasone propionate'] @entity617 :: ('MESH:D011239', 'Chemical') :: ['Prednisolone', 'prednisolone']
@entity1412 :: (MESH:D011125,Disease) :: ['nasal polyposis']
