Severe nasal polyposis and its impact on quality of life. The effect of a short course of oral steroids followed by long-term intranasal steroid treatment.
OBJECTIVE
Nasal polyposis is not a life-threatening disorder but has a great impact on the quality of life. Steroids constitute the first line of treatment of nasal polyps. The aims of this study were to evaluate the quality of life in nasal polyp patients after: (1) a short course of oral steroids; and (2) a long-term treatment with intranasal steroids.


METHODS
Patients with severe nasal polyps received either oral prednisone (n = 60) or no steroid treatment (control group, n = 18) for 2 weeks. Patients treated with steroids were also followed-up and evaluated after 12, 24, and 48 additional weeks with intranasal budesonide treatment.


RESULTS
Patients with nasal polyps showed worse scores on all SF-36 domains, except for physical functioning, compared to the Spanish general population. After two weeks, patients treated with oral prednisone demonstrated a significant improvement (p < 0.05) in all impaired QoL domains compared to both control group and baseline. The mental component summary (51.0 +/- 1.2, p < 0.05) and physical component summary (51.0 +/- 0.9, p < 0.05) were improved compared to both control group and baseline. The improvement of all SF-36 domains was sustained by intranasal budesonida (p < 0.05) after 12, 24, and 48 weeks. Nasal obstruction, sense of smell, and polyp size also improved after both the oral short course and the intranasal long-term steroids treatment (p < 0.05).


CONCLUSIONS
These results suggest that the treatment with a short-course of oral steroids improves the quality of life of patients with severe nasal polyps and that this effect is maintained by a long-term treatment with intranasal steroids.
Rhinology Unit, Department of Otorhinolaryngology (ICEMEQ), Hospital Clinic, Universitat de Barcelona, Spain.
Isam
I
Alobid
Pedro
P
Benitez
Laura
L
Pujols
Miguel
M
Maldonado
Manuel
M
Bernal-Sprekelsen
Antonio
A
Morello
Cesar
C
Picado
Joaquim
J
Mullol
D000281:Administration, Intranasal; D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D019819:Budesonide / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology / Q000503:physiopathology; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011241:Prednisone / Q000008:administration & dosage*; D011788:Quality of Life; D012903:Smell
D005938:Glucocorticoids; D019819:Budesonide; D011241:Prednisone