International Forum of Allergy & Rhinology
Excerpt: "Topical steroids remain the mainstay of therapy for chronic rhinosinusitis (CRS), especially chronic rhinosinusitis with eosinophilia. Douglas et al. report on a phase 1 clinical study of a novel biodegradable mometasone furoate drug delivery system for treating CRS in the unoperated patient. This is the first steroid-eluting implant intended for use in patients who have not had prior surgery, and elutes the steroid over a 24-week period. Up to this point in time, the only options for the management of CRS in patients who not had surgery have been either oral steroids, topical nasal steroid sprays (the latter have been demonstrated not to penetrate the middle meatus well), high-dose high-volume steroid nasal irrigations or, in patients with nasal polyposis, the use of an exhalation delivery system (EDS). In addition to demonstrating a high level of safety in this study, 70% of patients reported at least a minimal clinically important difference (MCID) in their 22-item Sino-Nasal Outcome Test (SNOT-22) by the end of the study, and the average change became significant by week 1. Given the phase 1 feature of this implant trial, and the primary emphasis on safety, post treatment imaging was not performed. However, clearly the device is worthy of further study and would appear to provide an alternative to the use of high-dose, high-volume steroid nasal irrigations and EDS in reducing the necessity of surgical intervention."