Mohammad Nabavi, Saba Arshi, Mohammad Hassan Bemanian, Morteza Fallahpour, Sima Shokri, Sofia Sabouri, Fatima Moosavian, Javad Nazari, Vahid Bakrani, Fatemeh Atashrazm
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A total of 100 patients were randomly assigned to receive either doxycycline (200 mg on the first day followed by 100 mg daily) or placebo for 6 weeks. All patients received baseline therapy with fluticasone, montelukast, and nasal irrigation during the study. The primary outcome was quality of life based on the sino-nasal outcome test (SNOT-22) questionnaire. We measured peak nasal inspiratory flow (PNIF) and severity of symptoms by visual analogue scale (VAS). Baseline blood eosinophil count, serum IgE level, eosinophil in nasal secretions, and Lund-Mackay score based on low dose paranasal CT scan were also recorded.</p><p><strong>Results: </strong>Treatment with doxycycline significantly improved SNOT-22 (<i>P </i>= .037) and sense of smell (<i>P </i>= .048). The baseline SNOT-22 score had no effect on outcomes. The effect of doxycycline on quality of life in patients with or without nasal eosinophilia was not significantly different. Change in SNOT-22 score was also not correlated with serum IgE (<i>P </i>= .220, <i>r </i>= -0.186) and the eosinophil count (<i>P </i>= .190, <i>r </i>= -0.198).</p><p><strong>Conclusion: </strong>Doxycycline improves the quality of life in patients with CRSwNP. It also has temporarily beneficial effects in improving the sense of smell. The levels of eosinophil in the blood and nasal secretions do not affect the response to treatment. 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Baseline blood eosinophil count, serum IgE level, eosinophil in nasal secretions, and Lund-Mackay score based on low dose paranasal CT scan were also recorded.</p><p><strong>Results: </strong>Treatment with doxycycline significantly improved SNOT-22 (<i>P </i>= .037) and sense of smell (<i>P </i>= .048). The baseline SNOT-22 score had no effect on outcomes. The effect of doxycycline on quality of life in patients with or without nasal eosinophilia was not significantly different. Change in SNOT-22 score was also not correlated with serum IgE (<i>P </i>= .220, <i>r </i>= -0.186) and the eosinophil count (<i>P </i>= .190, <i>r </i>= -0.198).</p><p><strong>Conclusion: </strong>Doxycycline improves the quality of life in patients with CRSwNP. It also has temporarily beneficial effects in improving the sense of smell. The levels of eosinophil in the blood and nasal secretions do not affect the response to treatment. 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引用次数: 2
摘要
背景:慢性鼻窦炎伴鼻息肉(CRSwNP)是一种复杂的疾病，有效的治疗仍然是一个主要的挑战。据报道，一些具有抗炎特性的抗生素有可能被用作慢性气道炎症管理的辅助治疗。目的:评价强力霉素治疗CRSwNP的疗效。方法:在这项随机、双盲、安慰剂对照研究中，我们评估了强力霉素对中重度CRSwNP患者的疗效。共有100名患者被随机分配接受强力霉素(第一天200毫克，随后每天100毫克)或安慰剂，为期6周。在研究期间，所有患者均接受氟替卡松、孟鲁司特和鼻腔冲洗的基线治疗。主要终点是基于鼻鼻结果测试(SNOT-22)问卷的生活质量。采用视觉模拟量表(VAS)测量鼻吸气流量峰值(PNIF)和症状严重程度。同时记录基线血嗜酸性粒细胞计数、血清IgE水平、鼻分泌物嗜酸性粒细胞以及基于低剂量鼻部CT扫描的隆德-麦凯评分。结果:多西环素治疗显著改善了SNOT-22 (P = 0.037)和嗅觉(P = 0.048)。基线SNOT-22评分对结果没有影响。强力霉素对有或无鼻嗜酸性粒细胞增多症患者生活质量的影响无显著差异。SNOT-22评分的变化与血清IgE也无相关性(P =。220, r = -0.186)，嗜酸性粒细胞计数(P =。190, r = -0.198)。结论:强力霉素可改善CRSwNP患者的生活质量。它对改善嗅觉也有暂时的有益作用。血液和鼻分泌物中嗜酸性粒细胞的水平不影响对治疗的反应。因此，强力霉素可用于嗜酸性和非嗜酸性鼻息肉。本研究已在伊朗临床试验注册中心注册。https://www.irct.ir/ IRCTID: IRCT20210403050817N1。
Doxycycline Improves Quality of Life and Anosmia in Chronic Rhinosinusitis With Nasal Polyposis: A Randomized Controlled Trial.
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex disorder and effective treatment remains a major challenge. Some antibiotics with anti-inflammatory properties are reported to have potential to be used as an adjunct therapy in the management of chronic airway inflammation.
Objective: The aim of this study was to evaluate the efficacy of doxycycline in CRSwNP.
Methods: In this randomized, double-blind, placebo-control study, we assessed the efficacy of doxycycline in patients with moderate to severe CRSwNP. A total of 100 patients were randomly assigned to receive either doxycycline (200 mg on the first day followed by 100 mg daily) or placebo for 6 weeks. All patients received baseline therapy with fluticasone, montelukast, and nasal irrigation during the study. The primary outcome was quality of life based on the sino-nasal outcome test (SNOT-22) questionnaire. We measured peak nasal inspiratory flow (PNIF) and severity of symptoms by visual analogue scale (VAS). Baseline blood eosinophil count, serum IgE level, eosinophil in nasal secretions, and Lund-Mackay score based on low dose paranasal CT scan were also recorded.
Results: Treatment with doxycycline significantly improved SNOT-22 (P = .037) and sense of smell (P = .048). The baseline SNOT-22 score had no effect on outcomes. The effect of doxycycline on quality of life in patients with or without nasal eosinophilia was not significantly different. Change in SNOT-22 score was also not correlated with serum IgE (P = .220, r = -0.186) and the eosinophil count (P = .190, r = -0.198).
Conclusion: Doxycycline improves the quality of life in patients with CRSwNP. It also has temporarily beneficial effects in improving the sense of smell. The levels of eosinophil in the blood and nasal secretions do not affect the response to treatment. Hence, doxycycline can be used in both eosinophilic and non-eosinophilic nasal polyps.This study was registered at Iranian Registry of Clinical Trials. https://www.irct.ir/ IRCTID: IRCT20210403050817N1.
期刊介绍：
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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