IMPORTANCE: @entity102 is a common inflammatory condition defined by persistent symptomatic @entity32 of the sinonasal cavities lasting longer than 3 months. It accounts for 1% to 2% of total physician encounters and is associated with large health care expenditures. Appropriate use of medical therapies for chronic @entity1244 is necessary to optimize @entity1 quality of life (QOL) and daily functioning and minimize the risk of acute inflammatory exacerbations. OBJECTIVE: To summarize the highest-quality evidence on medical therapies for adult chronic @entity1244 and provide an evidence-based approach to assist in optimizing @entity1 care. EVIDENCE REVIEW: A systematic review searched Ovid MEDLINE (1947-January 30, 2015), EMBASE, and Cochrane Databases. The search was limited to randomized clinical trials (RCTs), systematic reviews, and meta-analyses. Evidence was categorized into maintenance and intermittent or rescue therapies and reported based on the presence or absence of @entity480 . FINDINGS: Twenty-nine studies met inclusion criteria: 12 meta-analyses (>60 RCTs), 13 systematic reviews, and 4 RCTs that were not included in any of the meta-analyses. Saline irrigation improved symptom scores compared with no treatment (standardized mean difference [SMD], 1.42 [95% CI, 1.01 to 1.84]; a positive SMD indicates improvement). Topical corticosteroid therapy improved overall symptom scores (SMD, -0.46 [95% CI, -0.65 to -0.27]; a negative SMD indicates improvement), improved @entity1127 scores (SMD, -0.73 [95% CI, -1.0 to -0.46]; a negative SMD indicates improvement), and reduced @entity1127 recurrence after surgery (relative risk, 0.59 [95% CI, 0.45 to 0.79]). Systemic @entity288 and oral @entity3403 (both for 3 weeks) reduced @entity1127 size compared with placebo for 3 months after treatment (P   <   .001). @entity4352 antagonists improved nasal symptoms compared with placebo in @entity1 with @entity480 (P   <   .01). @entity7646 antibiotic for 3 months was associated with improved QOL at a single time point (24 weeks after therapy) compared with placebo for @entity1 without @entity1127 (SMD, -0.43 [95% CI, -0.82 to -0.05]). CONCLUSIONS AND RELEVANCE: Evidence supports daily high-volume saline irrigation with topical @entity228 therapy as a first-line therapy for chronic @entity1244 . A short course of systemic @entity288 (1-3 weeks), short course of @entity3403 (3 weeks), or a @entity4352 antagonist may be considered in @entity1 with @entity480 . A prolonged course (3 months) of @entity7646 antibiotic may be considered for @entity1 without @entity1127 .

Medical Therapies for Adult XXXX : A Systematic Review.

@entity1244 :: ('MESH:D012852', 'Disease') :: ['sinusitis'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1127 :: ('MESH:D011127', 'Disease') :: ['polyp', 'polyps'] @entity7646 :: ('CHEBI:25106', 'Chemical') :: ['macrolide', 'Macrolide'] @entity3403 :: ('MESH:D004318', 'Chemical') :: ['doxycycline'] @entity228 :: ('CHEBI:50858', 'Chemical') :: ['corticosteroid'] @entity102 :: ('MESH:D002908', 'Disease') :: ['Chronic sinusitis'] @entity4352 :: ('CHEBI:25029', 'Chemical') :: ['leukotriene', 'Leukotriene'] @entity480 :: ('MESH:D009298', 'Disease') :: ['nasal polyps'] @entity288 :: ('MESH:D000305', 'Chemical') :: ['corticosteroids']
@entity102 :: (MESH:D002908,Disease) :: ['Chronic Sinusitis']
