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<p>Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a persistent inflammatory condition of the sinonasal mucosa, often associated with eosinophilic infiltration and significant symptom burden. Oral corticosteroids (OCS) are widely used for short-term disease control, yet treatment response varies significantly across patients. This study aimed to evaluate the clinical, endoscopic, and histopathological response to short-course OCS in Indian patients with CRSwNP and identify predictors of treatment outcome. A prospective observational study was conducted at a tertiary care center in North India over 24&#xa0;months. Fifty adult patients with bilateral CRSwNP were treated with oral prednisolone (60&#xa0;mg/day for 7&#xa0;days, tapered over the next 7&#xa0;days), alongside intranasal corticosteroids. Clinical response was assessed using the SNOT-22 questionnaire and Lund-Kennedy endoscopic scores at baseline, Day 21, and 3&#xa0;months. Histological analysis of nasal biopsy specimens evaluated tissue eosinophils, neutrophils, and stromal fibrosis on day1 &amp; day 21. Logistic regression was used to identify predictors of steroid response. Sixty-eight percent of patients showed significant improvement in SNOT-22 and endoscopic scores post-treatment. Serum IgE levels reduced significantly (p = 0.001), while absolute eosinophil count showed a declining trend. Histopathology revealed a marked reduction in tissue eosinophilia (p = 0.001). Post-treatment eosinophil count ≤ 10/HPF was strongly associated with treatment response (OR 5.82, p = 0.006). At 3&#xa0;months, 41.2% of initial responders experienced symptom recurrence. Short-course OCS is effective in achieving short-term control in CRSwNP. Tissue eosinophilia is a robust predictor of response, aiding in early stratification and tailored treatment planning.</p>

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Therapeutic Efficacy of Oral Corticosteroids in Chronic Rhinosinusitis with Nasal Polyposis: A Prospective Evaluation in an Indian Cohort

  • 期刊论文

  • 发表日期：

    2025年9月5日

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  • Varun Jerath,
  • Manish Kumar Garg,
  • Rajeev Chugh,
  • Vikas Gupta,
  • Sanjay Kumar,
  • Abha Kumari,
  • S. K. Singh

摘要

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a persistent inflammatory condition of the sinonasal mucosa, often associated with eosinophilic infiltration and significant symptom burden. Oral corticosteroids (OCS) are widely used for short-term disease control, yet treatment response varies significantly across patients. This study aimed to evaluate the clinical, endoscopic, and histopathological response to short-course OCS in Indian patients with CRSwNP and identify predictors of treatment outcome. A prospective observational study was conducted at a tertiary care center in North India over 24 months. Fifty adult patients with bilateral CRSwNP were treated with oral prednisolone (60 mg/day for 7 days, tapered over the next 7 days), alongside intranasal corticosteroids. Clinical response was assessed using the SNOT-22 questionnaire and Lund-Kennedy endoscopic scores at baseline, Day 21, and 3 months. Histological analysis of nasal biopsy specimens evaluated tissue eosinophils, neutrophils, and stromal fibrosis on day1 & day 21. Logistic regression was used to identify predictors of steroid response. Sixty-eight percent of patients showed significant improvement in SNOT-22 and endoscopic scores post-treatment. Serum IgE levels reduced significantly (p = 0.001), while absolute eosinophil count showed a declining trend. Histopathology revealed a marked reduction in tissue eosinophilia (p = 0.001). Post-treatment eosinophil count ≤ 10/HPF was strongly associated with treatment response (OR 5.82, p = 0.006). At 3 months, 41.2% of initial responders experienced symptom recurrence. Short-course OCS is effective in achieving short-term control in CRSwNP. Tissue eosinophilia is a robust predictor of response, aiding in early stratification and tailored treatment planning.