title: Assessment of efficacy and safety of the herbal medicinal product BNO 1016 in chronic rhinosinusitis.
abstract: BACKGROUND
  The objective of this clinical trial (CRS-02) was to assess the efficacy, safety and tolerability of two dosages of the herbal medicinal product BNO 1016 (Sinupret extract) in patients with chronic rhinosinusitis (CRS).
  
  
  METHODS
  929 patients suffering from CRS were enrolled in this randomised placebo-controlled trial with a treatment period of 12 weeks. The primary endpoint was the mean Major Symptom Score (MSS) in week 8 and week 12 compared to placebo. Secondary endpoints included further MSS related parameters and responder rates over time. Pharmacoeconomic endpoints were also analysed. Finally, safety and tolerability were evaluated.
  
  
  RESULTS
  Sinupret extract was not superior over placebo regarding the primary endpoint. However, the results of the secondary endpoints showed a clear trend towards superior efficacy. Therefore, additional post-hoc sensitivity analyses were performed in patients with a baseline MSS over 9 and persistence of disease more than 1 year diagnosed by specialists in otorhinolaryngology. Those patients significantly benefited from Sinupret extract. Therapy was superior for the primary endpoint analysis. Patients were less impaired with respect to work and daily activities. A good safety and tolerability of Sinupret extract was assured in all patients.
  
  
  CONCLUSIONS
  Sinupret extract can safely be administered in patients with CRS. Although the primary endpoint of the study was not significant, a post-hoc subgroup analysis in patients whose disease was diagnosed by a specialist revealed a pronounced treatment effect. Effects in that subgroup were even stronger with longer disease persistence and stronger severity.
authors.affiliation: Rothenbach, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Palm
authors.affiliation: Posnan, Poland.
authors.forename: I
authors.initials: I
authors.lastname: Steiner
authors.affiliation: Bionorica SE, Neumarkt, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Abramov-Sommariva
authors.affiliation: Bionorica SE, Neumarkt, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Ammendola
authors.affiliation: Bionorica SE, Neumarkt, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Mitzenheim
authors.affiliation: Bionorica SE, Neumarkt, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Steindl
authors.affiliation: Bionorica SE, Neumarkt, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wonnemann
authors.affiliation: Ghent University Hospital, Ghent, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Bachert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000627:therapeutic use*; D012220:Rhinitis / Q000188:drug therapy* / Q000821:virology; D012852:Sinusitis / Q000188:drug therapy* / Q000821:virology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: C578474:BNO 1016; D010936:Plant Extracts