Is Verapamil Effective for Treating Patients With Chronic Rhinosinusitis With Nasal Polyps? A Systematic Review

Area of Science:

• Otolaryngology
• Pharmacology
• Clinical Trials

Background:

• Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) significantly impacts patient quality of life.
• Current treatment options for CRSwNP have limitations, necessitating exploration of novel therapeutic agents.

Purpose of the Study:

• To systematically review and summarize the evidence on the efficacy of low-dose verapamil in adult patients diagnosed with CRSwNP.
• To assess the impact of verapamil on both subjective symptom reporting and objective clinical measures in CRSwNP.

Main Methods:

• A systematic literature search was conducted until December 28, 2023, identifying three randomized controlled trials.
• PRISMA guidelines were followed for study selection and data extraction.
• Primary endpoints included quality-of-life questionnaires (e.g., SNOT-22) and objective imaging gradings (e.g., TNPS, LMS).

Main Results:

• Across 116 participants, verapamil significantly improved subjective symptom scores compared to placebo (SNOT-22 mean differences: -19.17 and -27.7).
• Two of the three studies demonstrated statistically significant improvements in objective metrics (TNPS or LMS).

Conclusions:

• Low-dose verapamil demonstrated significant improvements in both subjective and objective measures for CRSwNP.
• The current evidence is insufficient to recommend widespread verapamil use for CRSwNP.
• Future research requires larger sample sizes and methodologically robust, homogeneous study designs.