Journal of Personalized Medicine (May 2022)

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

  • Eugenio De Corso,
  • Carlotta Pipolo,
  • Elena Cantone,
  • Giancarlo Ottaviano,
  • Stefania Gallo,
  • Frank Rikki Mauritz Canevari,
  • Alberto Macchi,
  • Giulia Monti,
  • Carlo Cavaliere,
  • Ignazio La Mantia,
  • Sara Torretta,
  • Francesco Bussu,
  • Emanuele Scarano,
  • Paolo Petrone,
  • Angelo Ghidini,
  • Daniela Lucidi,
  • Massimiliano Garzaro,
  • Matteo Trimarchi,
  • Veronica Seccia,
  • Giulio Cesare Passali,
  • Daria Salsi,
  • Domenico Cuda,
  • Ernesto Pasquini,
  • Luca Malvezzi,
  • Stefano Settimi,
  • Gaetano Paludetti,
  • Jacopo Galli

DOI
https://doi.org/10.3390/jpm12060897
Journal volume & issue
Vol. 12, no. 6
p. 897

Abstract

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Background: Local and systemic corticosteroids have long been the workhorse in management of chronic rhinosinusitis with nasal polyps (CRSwNP), although there is no universally accepted modality of prescription. We carried out a survey in Italy to capture current trends in the use of topical and systemic corticosteroids in patients with CRSwNP. Methods: A survey was set up on Survey Monkey®. Each author distributed the link to the survey in an ad hoc manner and a total of 437 participants filled out the survey. Results: Mometasone furoate (79.3%) was the most frequently prescribed, administered daily by 61.9% of participants; the remaining preferred to discontinue treatment for brief periods to reduce side effects or to modulate the therapy in mild cases. The majority believe that a short cycle of systemic steroids should be prescribed for re-exacerbation of symptoms and that the number of cycles in the previous year should be evaluated to define control of the disease even if international guidelines do not provide clear indications on this topic. A certain degree of divergence emerged from responses regarding how long and the maximal dose of systemic steroids which place patients at high risk for adverse events. Finally, systemic corticosteroids seem to offer only temporary benefit on recovery of smell without guaranteeing long-term control even if the patient is adherent to topical corticosteroids. Conclusions: Our results highlight the need for clear guidelines on oral steroids, which could help supporting the use of a precision medicine approach, including indications for new biological agents.

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