- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02182492
Efficacy of Macrolide and Glucocorticoid in the Treatment of Chronic Rhinosinusitis After Endoscopic Sinus Surgery
Comparison of Different Efficacy of Macrolide and Glucocorticoid in the Treatment of Chronic Rhinosinusitis Patients After Endoscopic Sinus Surgery
Endoscopic sinus surgery (ESS) is widely considered to be the gold standard in the surgical management of chronic rhinosinusitis (CRS) that has failed maximal medical therapy. Nevertheless, the postoperation medical therapy was considered as a crucial procedure for the success of ESS. Both glucocorticoids and macrolide antibiotics have been recommended for the treatment of CRS, but their effect as postoperation medical therapies of ESS need more clinical data to clarify.
The purpose of this prospective, randomized,study is to determine the effect of glucocorticoids and macrolide antibiotics for the postoperation medical therapy of ESS in different subtypes of CRS.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Hubei
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Wuhan, Hubei, China, 430030
- Department of ENT, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Meeting the CRS diagnostic criteria including CRSsNP and CRSwNP based on the EP3OS definition
- Age ≥16 and ≤70 years
- Chinese of either sex
- Failure to conventional medical therapies according to EP3OS recommendation
Exclusion Criteria:
- Pregnant or breast-feeding women
- Cystic fibrosis
- Congenital ciliary dyskinesia
- Sinonasal fungal disease
- Systemic vasculitis
- Granulomatous disease
- Tumor
- Immunodeficiency
- Allergic to clarithromycin or topical corticosteroid
- With an upper respiratory tract infection within 4 weeks of entering the study
- With serious metabolic, cardiovascular, autoimmune, neurology, blood, digestive, cerebrovascular, respiratory system disease, or any disease interfering with the evaluation of results or affecting subjects' safety such as glaucoma and tuberculosis
- With emotional or mental problems
- Have received immunotherapy within the previous 3 months
- Have had a history of local or systemic medications, such as glucocorticoids and macrolides within 4 weeks
- Have had an acute asthmatic within the 4 weeks before entering the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Glucocorticoid
Fluticasone propionate nasal spray
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Fluticasone propionate nasal spray 200 μg/d for 3 months
Other Names:
|
EXPERIMENTAL: Clarithromycin
Clarithromycin tablet
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Clarithromycin 250 mg tablet once daily for 3 months
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total Subjective Symptoms Visual Analog Scores (VAS)
Time Frame: Scores will be recorded just before ESS and at 1-, 3-, 6- and 12-month follow-up visit.
|
The treatment will begin one week after ESS.
Symptoms visual analog scores (VAS) were recorded just before ESS and at 1-, 3-, 6- and 12-month follow-up visit.
All of the patients were assessed by using symptom questionnaire after enrollment and at follow-up visits.
Subjective symptoms were scored by patients on a VAS of 0-10, with 0 being "no complaint whatsoever" and 10 being "the worst imaginable complaint."Five
major symptoms were focused on: nasal obstruction, rhinorrhea, loss of sense of smell, facial pain or pressure, and headache.
Total VAS score was calculated based on the sum of VAS scores of these five symptom domains.
Total subjective symptoms VAS range: 0~50, with higher scores indicating greater severity of symptoms.
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Scores will be recorded just before ESS and at 1-, 3-, 6- and 12-month follow-up visit.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total Nasal Endoscopic Scores
Time Frame: Scores will be recorded just before ESS and at 1-, 3-, 6- and 12-month follow-up visit.
|
Nasal endoscopic evaluation was performed by the senior investigator who remained blinded to the treatment, including poly size: 0, absence of polyps; 1, polyps in middle meatus only; 2, polyps beyond middle meatus but not blocking the nose completely; and 3, polyps completely obstructing the nose; discharge: 0, no discharge; 1, clear thin discharge; 2, thick purulent discharge; edema: 0, no edema; 1, mild edema; 2, severe edema; crusting: 0, no crusting; 1, mild crusting; 2, severe crusting; scarring: 0, no scarring; 1, mild scarring; 2, severe scarring).
Each side was graded separately, and the scores from both sides were added to determine the overall scores for a particular domain.
The total endoscopy score was calculated based on the sum of scores of these endoscopic domains.
Endoscopic scores were also recorded before ESS (baseline) and at 1-, 3-, 6- and 12-month follow-up visits.
Total endoscopy score range: 0~22, with higher scores indicating greater severity.
|
Scores will be recorded just before ESS and at 1-, 3-, 6- and 12-month follow-up visit.
|
Other Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Measurement of Protein Levels of Inflammatory Molecules in Tissues
Time Frame: Polyp tissues from CRSwNP patients and diseased sinus mucosa from CRSsNP patients will be collected during surgery.
|
Polyp tissues from CRSwNP patients and diseased sinus mucosa from CRSsNP patients will be collected during surgery.
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Zheng Liu, Doctor, Professor of Otolaryngology-Head & Neck Surgery Vice Director Department of ENT Tongji Hospital Tongji Medical College Huazhong University of Science and Technology
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Otorhinolaryngologic Diseases
- Paranasal Sinus Diseases
- Nose Diseases
- Sinusitis
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Anti-Bacterial Agents
- Cytochrome P-450 CYP3A Inhibitors
- Cytochrome P-450 Enzyme Inhibitors
- Protein Synthesis Inhibitors
- Clarithromycin
- Glucocorticoids
Other Study ID Numbers
- ENTDrug-001
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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