Low Dose, Short-Term Oral Methylprednisolone for Nasal Polyps: A Randomized Double-Blind Placebo-Controlled Trial

Objectives: To determine the efficacy of a 7-day treatment of methylprednisolone 16mg in reducing the size of nasal polyps and on improvement of nasal symptoms. Methods: Design: Randomized double-blind placebo-controlled trial Setting: Out-patient department of the East Avenue Medical Center Patients: Patients 18 years old and above with nasal polyposis determined by history and endoscopic examination Results: There was a significant decrease in polyp size by an average of 16% (P < .05) among 12 out of the 23 patients (52.17 %) in the steroid group versus placebo. The treatment group also exhibited an improvement in nasal symptoms of rhinorrhea, congestion and anosmia compared to the placebo. Conclusion: Medical treatment with oral methylprednisolone given at a low dose of 16 mg for one week resulted in reduction of the size of nasal polyps and improved the symptoms of rhinorrhea, nasal congestion and anosmia. Other associated symptoms like headache, epistaxis, sneezing, itchiness, epiphora, cough, postnasal drip, throat discomfort, facial pain, eye complaints and fever did not differ between the steroid and placebo groups. Recommendation: One week of oral steroids can be used to treat nasal polyps initially. If there is response, this mode of management can be combined with a long-term course of intranasal steroid sprays9,10. Patients who do not respond may be referred for surgery. Keywords: Nasal polyposis, methylprednisolone, rhinorrhea, nasal congestion, anosmia

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Effects of low dose ramipril on cardiovascular and renal outcomes in patients with type 2 diabetes and raised excretion of urinary albumin: randomised, double blind, placebo controlled trial (the DIABHYCAR study)

BMJ ◽

10.1136/bmj.328.7441.686-b ◽

2004 ◽

Vol 328 (7441) ◽

pp. 686.3

Keyword(s):

Type 2 Diabetes ◽

Low Dose ◽

Controlled Trial ◽

Urinary Albumin ◽

Double Blind ◽

Double Blind Placebo ◽

Renal Outcomes

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Effect of low dose aspirin and dipyridamole on primary patency of arteriovenous grafts in hemodialysis patients: a randomized double-blind placebo-controlled trial

Electronic physician ◽

10.19082/6135 ◽

2018 ◽

Vol 10 (1) ◽

pp. 6135-6139 ◽

Cited By ~ 2

Author(s):

Pouya Tayebi ◽

Gholamhosein Kazemzadeh ◽

Azin Banihashem ◽

Hassan Ravari

Keyword(s):

Low Dose ◽

Controlled Trial ◽

Hemodialysis Patients ◽

Primary Patency ◽

Double Blind ◽

Double Blind Placebo ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Arteriovenous Grafts

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Effect of chemoprevention by low-dose aspirin of new or recurrent colorectal adenomas in patients with Lynch syndrome (AAS-Lynch): study protocol for a multicenter, double-blind, placebo-controlled randomized controlled trial

Trials ◽

10.1186/s13063-020-04674-8 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Adil Soualy ◽

◽

David Deutsch ◽

Mourad Benallaoua ◽

Amal Ait-Omar ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Lynch Syndrome ◽

Low Dose ◽

Controlled Trial ◽

Colorectal Adenomas ◽

Double Blind ◽

Double Blind Placebo ◽

Randomized Controlled ◽

Dose Aspirin ◽

Low Dose Aspirin

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Late Phase Inflammation during Nasal Grass and Ragweed Challenge in a Double-Blind Placebo Controlled Trial with Astemizole

American Journal of Rhinology ◽

10.2500/105065895781873863 ◽

1995 ◽

Vol 9 (3) ◽

pp. 169-174 ◽

Cited By ~ 1

Author(s):

Marianne Frieri ◽

James Madden ◽

Myron Zitt ◽

Nanjundaiah S. Kumar ◽

Maria Knapik

Keyword(s):

Allergic Rhinitis ◽

Nasal Congestion ◽

Controlled Trial ◽

Statistical Significance ◽

Interleukin 1 ◽

Late Phase ◽

Double Blind ◽

Double Blind Placebo ◽

Nasal Provocation ◽

Anti Inflammatory

Allergic rhinitis is an IgE-mediated inflammatory reaction characterized by an early “classic” immediate hypersensitivity response and/or a subsequent late phase response. Nasal provocation to antigen challenge is a useful method of evaluating this dual response. Several H1 antagonists may exhibit antiinflammatory properties by diminishing histamine release or inhibiting eosinophil chemotaxis. To determine whether astemizole has any anti-inflammatory characteristics, we studied 20 patients with allergic rhinitis in a double-blind placebo-controlled fashion after a 4-week course of treatment with this H1 antagonist. Nasal provocation over 30 minutes was performed out of season using increasing concentrations of grass or ragweed extract from 10–1000 PNU. Patients were evaluated for their clinical response, and nasal lavage secretions were analyzed over 6 hours by ELISA for alpha interleukin-1, interleukin-8, albumin, and histamine levels. Total sneezing and other symptom scores for rhinorrhea, nasal congestion, and pruritus were decreased in astemizole-treated compared to placebo-treated patients both at 30 minutes (early phase), and at 3 and 6 hours (late phase) after nasal provocation. However, these results did not reach statistical significance. Nasal α IL-1 levels diminished from diluent control lavage to a significantly greater degree in astemizole than in placebo-treated patients (P < 0.05). This diminution in late phase α IL-1 suggests that astemizole may possess anti-inflammatory properties.

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