title: Dornase alfa as postoperative therapy in cystic fibrosis sinonasal disease.
abstract: OBJECTIVE
  To determine the benefit of nasally inhaled dornase alfa in patients with cystic fibrosis and nasal symptoms.
  
  
  METHODS
  Double-blind placebo-controlled trial.
  
  
  METHODS
  Cystic Fibrosis Regional Center of Campania at the University of Naples "Federico II."
  
  
  METHODS
  A total of 24 patients with cystic fibrosis and chronic sinusitis.
  
  
  METHODS
  Patients underwent sinonasal surgery during a 3-year period and received once-daily doses of either dornase alfa (2.5 mg) or hypotonic saline solution (5 mL) beginning 1 month after surgery and for a 12-month period.
  
  
  METHODS
  Primary outcomes were nasal-related symptoms and nasal endoscopic appearance; secondary outcomes were forced expiratory volume in 1 second, nasal computed tomography findings, and saccharine clearance test results. Patients were evaluated before and after treatment.
  
  
  RESULTS
  After surgery, all outcomes were significantly improved for each treatment at 1 month (P<.05); primary outcomes were improved at 24 and 48 weeks in the group receiving dornase alfa (P<.05), and at 12 weeks in the group receiving placebo. Secondary outcomes were better in the dornase alfa group (P<.01) than in the placebo group at 12 months except for the saccharine clearance test results. In particular, median relative difference in forced expiratory volume in 1 second between dornase alfa and placebo was significantly improved in the dornase alfa group (P<.01).
  
  
  CONCLUSIONS
  Nasally inhaled dornase alfa can be effective in patients with cystic fibrosis and sinonasal disease who do not respond to conventional therapy after surgical treatment. Further studies should be carried out to determine the long-term effect on sinus disease, recurrence of polyps, and quality of life.
authors.affiliation: Department of Otorhinolaryngology, University of Naples Federico II, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Cimmino
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Nardone
authors.forename: Matteo
authors.initials: M
authors.lastname: Cavaliere
authors.forename: Angela
authors.initials: A
authors.lastname: Plantulli
authors.forename: Angela
authors.initials: A
authors.lastname: Sepe
authors.forename: Valeria
authors.initials: V
authors.lastname: Esposito
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Mazzarella
authors.forename: Valeria
authors.initials: V
authors.lastname: Raia
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D003850:Deoxyribonuclease I / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005100:Expectorants / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011446:Prospective Studies; D011994:Recombinant Proteins; D012852:Sinusitis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D005100:Expectorants; D011994:Recombinant Proteins; C085693:DNASE1 protein, human; D003850:Deoxyribonuclease I