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Tisch M, Roháč L, Reineke T, Burkart M, Kostev K. Long-term benefits of EPs ® 7630 in patients with acute sinusitis: a real-world cohort study. Front Pharmacol 2024; 15:1358879. [PMID: 38562459 PMCID: PMC10982470 DOI: 10.3389/fphar.2024.1358879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Background: We evaluated whether EPs® 7630 prescription in patients with acute sinusitis (AS) is associated with less frequent recurrence of AS, occurrence of chronic sinusitis or nasal polyps, or fewer antibiotic prescriptions. Methods: This retrospective cohort study used electronic medical records from the IQVIA Disease Analyzer database. Associations between initial therapy [EPs® 7630, antibiotics, intranasal corticosteroid (INCS), or corticosteroid-free nasal spray within 3 days of AS diagnosis] and AS recurrence, incidence of chronic sinusitis or nasal polyps or rate of antibiotic prescription were studied using multivariable Cox or logistic regression models, adjusting for sex, age, insurance status, month of diagnosis, and comorbidity. Results: A total of 216,360 patients were analyzed. INCS prescription was associated with a higher risk of recurrent AS (HR: 1.40; 95% CI: 1.01-1.92) and a higher incidence of chronic sinusitis or nasal polyp diagnosis (HR: 1.39; 95% CI: 1.01-1.92) compared to EPs® 7630. Initial antibiotic therapy was significantly associated with higher risk of new antibiotic prescription in the period of 31-365 days after the index date compared to EPs® 7630 (OR: 2.20; 95% CI: 1.66-2.92). Conclusion: EPs® 7630 prescription is associated with long-term benefits in AS patients. EPs® 7630 can help to reduce inappropriate antibiotic use and might reduce the risk of chronic sinusitis or nasal polyps.
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Affiliation(s)
- Matthias Tisch
- Department of Otorhinolaryngology, Head- and Neck Surgery, Bundeswehrkrankenhaus, Ulm, Germany
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Cui J, Lin W, May BH, Luo Q, Worsnop C, Zhang AL, Guo X, Lu C, Li Y, Xue CC. Orally administered Chinese herbal therapy to assist post-surgical recovery for chronic rhinosinusitis-A systematic review and meta-analysis. PLoS One 2023; 18:e0292138. [PMID: 37797052 PMCID: PMC10553817 DOI: 10.1371/journal.pone.0292138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/07/2023] [Indexed: 10/07/2023] Open
Abstract
This systematic review and meta-analysis aims to: assess the effectiveness and safety of orally administered Chinese herbal medicines (CHMs) as adjuncts to the post-surgical management of chronic rhinosinusitis (CRS); inform clinicians of the current evidence; identify the best available evidence; and suggest directions for further research. Randomised controlled trials (RCTs) were identified from searches of nine databases plus clinical trial registries. Participants were adults and/or children diagnosed with sinusitis or rhinosinusitis, with or without nasal polyps, who had received surgery. Interventions were CHMs used orally following surgery for CRS as additions to conventional post-surgical management. Controls received conventional post-surgical management without CHMs. Studies reported results for Sino-Nasal Outcome Test (SNOT), visual analogue scales (VAS), Lund-Mackay computed tomography score (LM), Lund-Kennedy endoscopic score (LK), mucociliary transport time (MTT), mucociliary transport rate (MTR), mucociliary clearance (MC) or quality of life (QoL). Twenty-one RCTs were included. All used oral CHMs following functional endoscopic sinus surgery (FESS). The pooled results showed no significant difference between groups for SNOT-20 at the end of treatment (EoT) but there was a significant difference at follow up (FU) in favour of additional CHMs. The VAS for total nasal symptoms (VAS-TNS) showed greater improvements in the CHM groups at EoT and FU. Only FU data were reported for LM which showed greater improvement in the CHM groups. LK showed greater improvements at EoT and FU. The measures of mucociliary transport (MTT, MTR, and MC) each showed significantly greater improvement at EoT in the group that received additional CHMs. No study reported QoL. Adverse events were not serious, but reporting was incomplete. The meta-analyses suggested the addition of oral CHMs to conventional management following FESS may improve recovery. However, most studies were not blinded, and substantial heterogeneity was evident in some meta-analyses. Blinded studies are required to further investigate the roles of oral CHMs in post-surgical recovery. Systematic review registration number: The protocol was registered in PROSPERO (CRD42019119586).
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Affiliation(s)
- Jing Cui
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Wenmin Lin
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Otorhinolaryngology Head and Neck Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Brian H. May
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Qiulan Luo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Otorhinolaryngology Head and Neck Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Christopher Worsnop
- Department of Respiratory Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Anthony Lin Zhang
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Xinfeng Guo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuanjian Lu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yunying Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Otorhinolaryngology Head and Neck Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Charlie C. Xue
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
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Taw MB, Nguyen CT, Wang MB. Integrative Approach to Rhinosinusitis: An Update. Otolaryngol Clin North Am 2022; 55:947-963. [PMID: 36088158 DOI: 10.1016/j.otc.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Rhinosinusitis is characterized by inflammation of the mucosa involving the paranasal sinuses and the nasal cavity and is one of the most common and significant health care problems, with significant impairment of quality of life. Current standard conventional management of rhinosinusitis commonly uses multiple therapeutic modalities to break the cycle of chronic disease. However, to date, there is no consensus as to the optimal treatment algorithm for patients with chronic rhinosinusitis. There is a growing interest in the use of complementary and integrative medicine for the treatment of rhinosinusitis. This article update focuses on an integrative approach to rhinosinusitis.
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Affiliation(s)
- Malcolm B Taw
- UCLA Center for East-West Medicine, 1250 La Venta Drive, Suite 101A, Westlake Village, CA 91361, USA.
| | - Chau T Nguyen
- Division of Otolaryngology-Head & Neck Surgery, Ventura County Medical Center, 300 Hillmont Avenue, Suite 401, Ventura, CA 93003, USA
| | - Marilene B Wang
- UCLA Department of Head and Neck Surgery, 200 UCLA Medical Plaza, Suite 550, Los Angeles, CA 90095, USA
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Lee B, Kwon CY, Park MY. Herbal medicine for the treatment of chronic rhinosinusitis: A systematic review and meta-analysis. Front Pharmacol 2022; 13:908941. [PMID: 35924061 PMCID: PMC9341451 DOI: 10.3389/fphar.2022.908941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: Chronic rhinosinusitis (CRS) is a disease with a high prevalence and a high socioeconomic burden. This study aimed to conduct a comprehensive systematic review to update the evidence on the use of herbal medicine (HM) for CRS treatment.Methods: A total of 14 electronic databases for randomized controlled trials (RCTs) evaluating the effects of HM on the treatment of CRS were searched for articles published before July 2021. The primary outcome was CRS severity post-treatment, measured with the Visual Analogue Scale (VAS) and Total Effective Rate (TER). The risk of bias of the included studies and the quality of evidence of the main findings were assessed using the Cochrane Collaboration’s risk of bias tool and the Grading of Recommendations, Assessment, Development, and Evaluations tool.Results: A total of 80 RCTs were included. Compared to placebo, HM significantly improved CRS severity as measured by TER and VAS. When HM was compared with conventional treatment (CT) as monotherapy or adjuvant therapy, CRS severity measured by TER and VAS, quality of life, Lund-Kennedy endoscopy score, Lund-Mackay computed tomography score, and nasal mucociliary function were significantly improved in the HM group. No serious adverse events associated with HM were reported. The risk of bias was generally unclear, and the quality of evidence ranged from moderate to low.Conclusion: This review found some limited clinical evidence that HM or HM combined with CT may be more effective and safer than CT alone in treating CRS. However, the methodological quality of the included studies was generally low, and the quality of the evidence needs to be improved.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, South Korea
| | - Man Young Park
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- *Correspondence: Man Young Park,
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Tatar A, Korkmaz M, Yayla M, Polat E, Uslu H, Halici Z, Parlak SN. The potential role of amlodipine on experimentally induced bacterial rhinosinusitis. Braz J Otorhinolaryngol 2016; 83:619-626. [PMID: 27769794 PMCID: PMC9449041 DOI: 10.1016/j.bjorl.2016.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 07/24/2016] [Accepted: 08/09/2016] [Indexed: 01/29/2023] Open
Abstract
Introduction Antibiotics are frequently used for the treatment of rhinosinusitis. Concerns have been raised regarding the adverse effects of antibiotics and growing resistance. The lack of development of new antibiotic compounds has increased the necessity for exploration of non-antibiotic compounds that have antibacterial activity. Amlodipine is a non-antibiotic compound with anti-inflammatory activity. Objective In this study we aimed to investigate the potential role of amlodipine in the treatment of rhinosinusitis by evaluating its effects on tissue oxidative status, mucosal histology and inflammation. Methods Fifteen adult albino guinea pigs were inoculated with Staphylococcus aureus and treated with saline, cefazolin sodium, or amlodipine for 7 days. The control group was composed by five healthy guinea pigs. Animals were sacrificed after the treatment. Histopathological changes were identified using Hematoxylin-Eosin staining. Inflammation was assessed by Polymorphonuclear Leukocyte infiltration density. Tissue levels of antioxidants (superoxide dismutase, glutathione) and an oxidative product (malondialdehyde) were determined. Results In rhinosinusitis induced animals, amlodipine reduced loss of cilia, lamina propria edema and collagen deposition compared to placebo (saline) and although not superior to cefazolin, amlodipine decreased polymorphonuclear leukocyte infiltration. The superoxide dismutase activity and glutathione levels were reduced, whereas the malondialdehyde levels were increased significantly in all three-treatment groups compared to the control group. Amlodipine treated group showed significantly increased superoxide dismutase and glutathione levels and decreased malondialdehyde levels compared to all treatment groups. Conclusion The non-antibiotic compound amlodipine may have a role in acute rhinosinusitis treatment through tissue protective, antioxidant and anti-inflammatory mechanisms.
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Affiliation(s)
- Arzu Tatar
- Ataturk University, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Erzurum, Turkey.
| | - Mukadder Korkmaz
- Ordu University, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Ordu, Turkey
| | - Muhammed Yayla
- Kafkas University, Medical Faculty, Department of Pharmacology, Kars, Turkey
| | - Elif Polat
- Ataturk University, Medical Faculty, Department of Embryology and Histology, Erzurum, Turkey
| | - Hakan Uslu
- Ataturk University, Medical Faculty, Department of Medical Microbiology, Erzurum, Turkey
| | - Zekai Halici
- Ataturk University, Medical Faculty, Department of Pharmacology, Erzurum, Turkey
| | - Secil N Parlak
- Ataturk University, Medical Faculty, Department of Embryology and Histology, Erzurum, Turkey
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Kogan M, Castillo CC, Barber MS. Chronic Rhinosinusitis and Irritable Bowel Syndrome: A Case Report. Integr Med (Encinitas) 2016; 15:44-54. [PMID: 27547167 PMCID: PMC4982648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Chronic rhinosinusitis (CRS) and irritable bowel syndrome (IBS) can be comorbidities that are difficult to treat. In this patient, an evidence-informed treatment pathway guided by laboratory biomarkers was used to address both conditions. CASE PRESENTATION A 69-y-old female patient presented with a 50-y history of sinusitis that was worse in the winter, postnasal drip, frequent sore throats, gastrointestinal complaints, headaches, and yeast infections. Two sinus surgeries (in years 2000 and 2002) and multiple courses of antibiotics had not resolved her sinus symptoms. In addition to CRS and IBS, this patient was noted to have intestinal overgrowth of Candida albicans, multiple food sensitivities, and leaky gut syndrome. CONCLUSION Antifungal medication and dietary changes in the course of 8 mo resulted in the resolution of her CRS and IBS.
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Affiliation(s)
- Mikhail Kogan
- Corresponding author: Mikhail Kogan, md E-mail address:
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Yen HR, Sun MF, Lin CL, Sung FC, Wang CC, Liang KL. Adjunctive traditional Chinese medicine therapy for patients with chronic rhinosinusitis: a population-based study. Int Forum Allergy Rhinol 2014; 5:240-6. [PMID: 25511322 DOI: 10.1002/alr.21446] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 09/24/2014] [Accepted: 10/13/2014] [Indexed: 01/18/2023]
Affiliation(s)
- Hung-Rong Yen
- Research Center for Traditional Chinese Medicine; Department of Medical Research, China Medical University Hospital; Taichung Taiwan
- Department of Chinese Medicine; China Medical University Hospital; Taichung Taiwan
- Research Center for Chinese Medicine and Acupuncture; China Medical University; Taichung Taiwan
- School of Chinese Medicine; China Medical University; Taichung Taiwan
| | - Mao-Feng Sun
- Department of Chinese Medicine; China Medical University Hospital; Taichung Taiwan
- Research Center for Chinese Medicine and Acupuncture; China Medical University; Taichung Taiwan
- School of Chinese Medicine; China Medical University; Taichung Taiwan
| | - Cheng-Li Lin
- Health Data Management Office; China Medical University Hospital; Taichung Taiwan
| | - Fung-Chang Sung
- Graduate Institute of Clinical Medical Science; China Medical University; Taichung Taiwan
| | - Chen-Chi Wang
- Department of Otolaryngology; Taichung Veterans General Hospital; Taichung Taiwan
- Department of Medicine; National Yang-Ming Medical University; Taipei Taiwan
| | - Kai-Li Liang
- Department of Otolaryngology; Taichung Veterans General Hospital; Taichung Taiwan
- Department of Medicine; National Yang-Ming Medical University; Taipei Taiwan
- School of Medicine; Chung Shan Medical University; Taichung Taiwan
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Schmidt-Weitmann S, Jenny K, Neuhaus Bühler R, Saller R, Brockes C. Medical online consultation service in CAM at the University Hospital Zurich. Forsch Komplementmed 2014; 21:19-24. [PMID: 24603626 DOI: 10.1159/000358502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The University Hospital Zurich offers medical online consultation services in individual health concerns. We examined the need for users' information in the field of CAM. For this purpose, the content of the questions, the users' profiles, and the online responses of the physicians were analyzed. METHODS The retrospective study analyzed 154 (1.3%) out of 11,827 questions and responses, selected by a literature-based keyword list between 2006 and 2007. They were evaluated by means of an inductive category system described by Mayring using a professional text analysis program (MAXQDA). Frequencies and mean values of the categories were statistically determined. RESULTS Users (aged 39.2 ± 16, females 61%) asked questions, which were in 73% allocated to herbal medicine, 7% to homeopathy, and 2% to acupuncture. The questions referred to medical fields, such as gynecology (18%), dermatology (13%), psychiatry (11%), and oncology (8%). One third of the responses provided detailed information about herbal treatment options. CONCLUSIONS The email-based online consultation service was used as a source of medical information in order to get more professional consultation in the field of CAM. Future scientific evaluation should investigate if online consultation services which are embedded in an environment of highly qualified health professionals may contribute to a better health literacy and empowerment of the patients.
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