Combined Oral and Intranasal Corticosteroid Therapy for Nasal Polyps
Authors: Sriram Vaidyanathan, Martyn Barnes, Peter Williamson, Pippa Hopkinson, Peter T. Donnan, Brian Lipworth
Journal: Annals of Internal Medicine (2011)

Letters16 August 2011Combined Oral and Intranasal Corticosteroid Therapy for Nasal PolypsSriram Vaidyanathan, MBBS, Martyn Barnes, MBChB, Peter Williamson, MBChB, Pippa Hopkinson, Peter T. Donnan, MD, and Brian Lipworth, MDSriram Vaidyanathan, MBBSFrom Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom; Ninewells Hospital and University of Dundee, Dundee DD2 4BF, United Kingdom; and Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom.Search for more papers by this author, Martyn Barnes, MBChBFrom Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom; Ninewells Hospital and University of Dundee, Dundee DD2 4BF, United Kingdom; and Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom.Search for more papers by this author, Peter Williamson, MBChBFrom Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom; Ninewells Hospital and University of Dundee, Dundee DD2 4BF, United Kingdom; and Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom.Search for more papers by this author, Pippa HopkinsonFrom Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom; Ninewells Hospital and University of Dundee, Dundee DD2 4BF, United Kingdom; and Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom.Search for more papers by this author, Peter T. Donnan, MDFrom Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom; Ninewells Hospital and University of Dundee, Dundee DD2 4BF, United Kingdom; and Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom.Search for more papers by this author, and Brian Lipworth, MDFrom Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom; Ninewells Hospital and University of Dundee, Dundee DD2 4BF, United Kingdom; and Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-4-201108160-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We thank Drs. Mullol and Alobid (1) for bringing prominence to a much-ignored but debilitating illness and would like to discuss several points raised by their editorial. First, the editorial proposes that differences between groups in the primary outcomes of polyp size and olfaction do not endure at 28 weeks. Our interpretation of the data is that over the 28-week period, the significant overall differences were −1.1 units (95% CI, −1.5 to −0.6 unit; P < 0.001) for polyp score and 15.40 mm (CI, −25.85 to −4.95 mm; P = 0.004) for hyposmia score (Table 2 in ...References1. Mullol J, Alobid I. Combined oral and intranasal corticosteroid therapy: an advance in the management of nasal polyposis? [Editorial]. Ann Intern Med. 2011;154:365-7. [PMID: 21357913] LinkGoogle Scholar2. Vaidyanathan S, Barnes M, Williamson P, Hopkinson P, Donnan PT, Lipworth B. Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med. 2011;154:293-302. [PMID: 21357906] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sriram Vaidyanathan, MBBS; Martyn Barnes, MBChB; Peter Williamson, MBChB; Pippa Hopkinson; Peter T. Donnan, MD; Brian Lipworth, MDAffiliations: From Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom; Ninewells Hospital and University of Dundee, Dundee DD2 4BF, United Kingdom; and Ninewells Hospital and University of Dundee, Dundee DD1 9SY, United Kingdom.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M09-2840. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCombined Oral and Intranasal Corticosteroid Therapy: An Advance in the Management of Nasal Polyposis? Joaquim Mullol and Isam Alobid Treatment of Chronic Rhinosinusitis With Nasal Polyposis With Oral Steroids Followed by Topical Steroids Sriram Vaidyanathan , Martyn Barnes , Peter Williamson , Pippa Hopkinson , Peter T. Donnan , and Brian Lipworth Metrics Cited byAtopy as a specific predictor of response to systemic and local steroid therapy in patients with chronic rhinosinusitis without nasal polypsLack of additive benefit of oral steroids on short‐term postoperative outcomes in nasal polyposisPrecision medicine: why surgeons deviate from “appropriateness criteria” in the management of chronic rhinosinusitis and effects on outcomesLeitlinie „Rhinosinusitis“ – LangfassungThe optimal evaluation and management of patients with a gradual onset of olfactory lossEvidence-based approach to medical and surgical treatment of nasal polyposisChronic sinusitis pathophysiology: The role of allergy 16 August 2011Volume 155, Issue 4Page: 277-278KeywordsAnalysis of covarianceAsthmaChronic obstructive pulmonary diseaseClinical trialsConflicts of interestCorticosteroid therapyDisclosureSteroid therapy ePublished: 16 August 2011 Issue Published: 16 August 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. 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