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Corticosteroids failed to provide relevant relief to patients with acute sinusitis

Corticosteroid monotherapy provided no clinically relevant benefits among patients diagnosed with acute sinusitis in a recent study.

Researchers in the Netherlands conducted a randomized, double blind placebo-controlled trial of 174 adult patients with acute sinusitis to test the effectiveness of oral prednisolone. Patients were assigned either 30 mg daily prednisolone (n=88) or placebo (n=86) for 7 days. All completed a 2-week diary describing their symptoms, including relief from facial pain or pressure, nasal congestion, cough and runny nose.

At day 7, 62.5% of the prednisolone group reported resolved facial pain or pressure compared with 55.8% of the placebo group (absolute risk difference=6.7%; 95% CI, –7.9% to 21.2%). Researchers found similar results that also were not statistically significant between groups, including nasal congestion (57.5% vs. 53.5%; absolute risk difference=4%; 95% CI, –10.8% to 18.8%), cough (66.3% vs. 54.8%; absolute risk difference=11.5%; 95% CI, –3.1% to 26.1%) and runny nose (69.3% vs. 58.1%; absolute risk difference=11.2%; 95% CI, –3% to 25.3%).

Adverse events, considered mild, were not significantly different between groups. Median duration of total symptoms — combined runny nose, postnasal discharge, congestion, cough and facial pain — was 7 days among prednisolone patients and 9 days for the placebo group (P=.2).

“We feel that there is no rationale for the use of corticosteroids in the broad population of patients with clinically diagnosed acute rhinosinusitis and instead advocate symptomatic treatment,” the researchers concluded. “Future studies should focus on identifying subgroups of patients who may benefit from intranasal or systemic corticosteroid treatment.”

Disclosure: See the study for a full list of relevant disclosures.