Are oral steroids and doxycycline effective in patients with nasal polyps?
A subgroup of patients suffering from chronic rhinosinusitis with nasal polyps (CRSwNP) remains insufficiently treated with topical glucocorticosteroids (GCSs); oral GCSs or antibiotics targeting the bacterial colonization might represent valid options, but thus far evidence is scant. GCSs have potent anti-inflammatory action, and antibiotics—particularly in patients with disease exacerbated by the Staphylococcus aureus enterotoxins—might then be indicated for treatment. In a study appearing in this month’s issue of the Journal, Van Zele et al conducted a double-blind, placebo controlled trial with 3 weeks’ treatment of either oral methylprednisolone or doxycycline and 9 weeks’ follow-up in CRSwNP patients. The authors found that oral GCS treatment significantly reduced nasal polyp size, symptoms, and local inflammatory parameters. However, the effect of methylprednisolone was short-lived and patients had a complete recurrence of polyps earlier than 2 months after treatment. Oral doxyc
