Small Benefit of Inhaled Corticosteroids for Sinusitis

Review shows benefits may be greater at increased doses and with courses of several weeks duration

TUESDAY, May 15 (HealthDay News) -- For patients with acute sinusitis, inhaled corticosteroids provide a small benefit over placebo but only after several weeks, according to a study published in the May/June issue of the Annals of Family Medicine.

Gail Hayward, M.B.B.Chir., D.Phil., from Oxford University in the United Kingdom, and colleagues conducted a systematic review and meta-analysis of studies to investigate the effect of intranasal corticosteroids on the symptoms of acute sinusitis. Six studies, including 2,495 patients with suspected acute sinusitis or rhinosinusitis, who were treated with intranasal corticosteroids or placebo, were included. Antibiotics were also prescribed in five of the studies.

The researchers found that intranasal corticosteroids were associated with a small but significant increase in symptom resolution or improvement at days 14 to 21 (risk difference, 0.08), with the most consistently significant benefits seen for facial pain and congestion. There was a significant beneficial effect noted at 21 days, but not at 14 to 15 days, in subgroup analysis by time of reported outcomes. A significant dose-response relationship was seen on analysis of trials using different doses of mometasone furoate.

"Most patients want to get better in a few days, not three weeks," John Hickner, M.D., M.Sc., from the Cleveland Clinic, writes in an accompanying editorial. "Nasal steroids are not the answer for most patients."

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