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Systemic corticosteroid monotherapy for clinically diagnosed acute rhinosinusitis: a randomized controlled trial
Roderick P Venekamp1, Marc J M Bonten, Maroeska M Rovers
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. r.p.venekamp@umcutrecht.nl
Summary
Systemic corticosteroids did not significantly improve symptoms for acute rhinosinusitis patients. This randomized controlled trial found no clinically relevant benefits of prednisolone over placebo for facial pain or pressure relief.
Area of Science:
- Otolaryngology
- Primary Care Medicine
- Clinical Pharmacology
Background:
- Acute rhinosinusitis is common in primary care settings.
- Evidence for corticosteroid use in acute rhinosinusitis is inconclusive.
- Systemic corticosteroid monotherapy effectiveness requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of systemic corticosteroid monotherapy for acute rhinosinusitis.
- To compare prednisolone with placebo in treating uncomplicated acute rhinosinusitis.
- To assess symptom resolution, particularly facial pain and pressure.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- 174 adult patients with clinically diagnosed acute rhinosinusitis were included.
- Patients received either prednisolone 30 mg/d or placebo for 7 days.
Main Results:
- No significant difference in facial pain or pressure resolution on day 7 between prednisolone and placebo groups (62.5% vs 55.8%).
- Similar symptom reduction over time and health-related quality of life in both groups.
- Adverse events were mild and comparable between treatment and placebo.
Conclusions:
- Systemic corticosteroid monotherapy offers no clinically relevant benefits for acute rhinosinusitis.
- Prednisolone is not more effective than placebo in resolving symptoms of acute rhinosinusitis.
- Current evidence does not support the routine use of systemic corticosteroids for this condition.
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