Document Detail


Non-specific bronchial hyperresponsiveness is a risk factor for steroid insensitivity in nasal polyposis.
MedLine Citation:
PMID:  15143747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Management of nasal polyposis should be primarily medical. Resorting to intranasal ethmoidectomy should not be envisaged before a trial of dual steroid therapy. Nevertheless, no risk factor for steroid insensitivity in patients with nasal polyposis is actually defined. The aim of this study is to evaluate whether the presence of asthma and/or non-specific bronchial hyperresponsiveness (BHR) can be considered a risk factor for steroid insensitivity. MATERIAL AND METHODS: This study focused on the evaluation of a dual modality, topical and systemic, over a follow-up period of 3 years. A total of 55 subjects with and 45 subjects without BHR were treated according to a standardized therapeutic protocol combining short-term oral administration of prednisolone and a daily intranasal spray of beclomethasone. RESULTS: Over the follow-up period of 3 years, this dual modality proved to be successful in 93.4% of subjects without BHR and without aspirin idiosyncrasy, in 82.2% of subjects with BHR and without aspirin idiosyncrasy and in 60% of subjects with BHR and aspirin idiosyncrasy. The percentage of patients who underwent surgery after the failure of medical treatment was significantly larger in patients with than without BHR (p < 0.05) and in patients with than without aspirin idiosyncrasy (p < 0.02). CONCLUSION: The presence of BHR and/or aspirin idiosyncrasy can be considered a major risk factor for steroid insensitivity in patients with nasal polyposis.
Authors:
Pierre Bonfils; Paul Avan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta oto-laryngologica     Volume:  124     ISSN:  0001-6489     ISO Abbreviation:  Acta Otolaryngol.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-05-14     Completed Date:  2005-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370354     Medline TA:  Acta Otolaryngol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  290-6     Citation Subset:  IM    
Affiliation:
ENT Research Laboratory and Department of Otolaryngology, Head and Neck Surgery I, European Hospital Georges Pompidou, Faculty Necker-Enfants Malades, University René Descartes, Paris, France. pierre.bonfils@egp.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aerosols
Anti-Asthmatic Agents / therapeutic use
Anti-Inflammatory Agents, Non-Steroidal / adverse effects
Antineoplastic Agents, Hormonal / therapeutic use
Aspirin / adverse effects
Asthma / complications*,  drug therapy,  physiopathology
Beclomethasone / administration & dosage,  therapeutic use*
Bronchial Hyperreactivity / complications*,  drug therapy
Bronchial Provocation Tests
Drug Hypersensitivity / complications
Drug Resistance
Ethmoid Sinus / radiography,  surgery
Female
Follow-Up Studies
Glucocorticoids / administration & dosage,  therapeutic use*
Humans
Irrigation
Male
Middle Aged
Nasal Polyps / complications,  drug therapy*
Prednisolone / administration & dosage,  therapeutic use*
Risk Factors
Tablets
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Aerosols; 0/Anti-Asthmatic Agents; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antineoplastic Agents, Hormonal; 0/Glucocorticoids; 0/Tablets; 4419-39-0/Beclomethasone; 50-24-8/Prednisolone; 50-78-2/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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