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Oral Corticosteroids Ineffective for Rhinosinusitis

Findings were similar for systemic prednisolone and placebo

In a randomized, placebo-controlled trial conducted by researchers at the University Medical Center Utrecht in the Netherlands, adult patients visiting primary-care practices for acute rhinosinusitis were randomly assigned to receive either prednisolone 30 mg/d (n = 88) or placebo (n = 86) for 7 days. The patients completed a symptom diary for 14 days.

The investigators found that the proportion of patients with resolution of facial pain or pressure on Day 7 was 62.5% in the prednisolone group versus 55.8% in the placebo group (absolute risk difference, 6.7%; 95% confidence interval, -7.9% to 21.2%). The two groups were also similar with regard to the decrease over time in the proportion of patients with total symptoms (combined symptoms of runny nose, postnasal discharge, nasal congestion, cough, and facial pain) and health-related quality of life. Adverse events were mild and similar in both groups.

The authors concluded that systemic corticosteroid monotherapy provides no clinically relevant beneficial effects in patients with acute rhinosinusitis.

For more information, visit the CMAJ Web site.

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