Mometasone 0.1% ointment 10% in White soft paraffin

Chronic rhinosinusitis (CRS), with or without nasal polyps (CRSwNP/CRSsNP), is a prevalent inflammatory condition of the sinonasal mucosa, for which intranasal corticosteroids (INCS) are widely used as first-line therapy. This systematic review evaluated the efficacy and safety of INCS, used alone or with adjunctive treatments, in improving clinical outcomes in CRS patients. A comprehensive literature search was conducted across PubMed, Cochrane Library, Scopus, Web of Science, and the Virtual Health Library (VHL) through May 2025, including randomized controlled trials (RCTs) assessing INCS efficacy in adults and children with CRS. Outcomes examined included nasal polyp score (NPS), nasal congestion, quality of life (QoL), sinus opacification, olfactory function, acute exacerbations, and adverse events. Six high-quality RCTs involving 2,339 participants were included. Dupilumab demonstrated the greatest NPS reduction (Δ-2.06), improved nasal congestion, and reduced the need for surgery or systemic steroids. Mepolizumab, omalizumab, and benralizumab were also effective in reducing polyp size and symptoms, particularly in eosinophilic CRS. EDS-FLU (exhalation delivery system with fluticasone) improved congestion, SNOT-22 (22-item Sino-Nasal Outcome Test) scores, and reduced acute exacerbations. In pediatric patients, mometasone delivered with saline nebulization significantly improved SN-5 scores. All interventions were well tolerated, with few adverse events reported. Overall, INCS are effective in managing CRS symptoms and reducing disease burden, particularly when combined with biologics or advanced delivery systems, and remain a cornerstone of CRS management with a strong safety and efficacy profile across diverse populations.

Abstract licence: CC BY

Background/Objectives: Paediatric Obstructive Sleep Apnoea (OSA) is characterised by recurrent episodes of upper airway obstruction during sleep, manifesting as snoring, intermittent oxygen desaturation, and frequent nocturnal awakenings. Standard treatments include surgical interventions, pharmacological therapies, intranasal corticosteroids, and oral montelukast. However, significant variability exists across studies regarding dosage and outcome assessment. This literature review systematically evaluated clinical evidence regarding the efficacy and safety of intranasal corticosteroids and oral montelukast for treating sleep-disordered breathing and its primary underlying condition, adenoid hypertrophy, in otherwise healthy children. Methods: The MEDLINE (PubMed), Scopus, and Web of Science databases were systematically searched up to 13 February 2025, using tailored search terms combining keywords and synonyms related to paediatric OSA, adenoidal hypertrophy, corticosteroids, montelukast, and randomised controlled trials. Owing to variability in outcome measures, Fisher's method for p-value combination was employed to enable a comprehensive comparison of drug effects. Results: Available evidence shows that intranasal corticosteroids (mometasone, beclometasone, budesonide, fluticasone, and flunisolide), either as monotherapy or in combination with other agents, consistently lead to clinical and instrumental improvements in adenoid hypertrophy and related respiratory symptoms, with a generally favourable safety profile. Combining montelukast with intranasal corticosteroids appears to offer superior benefits compared with monotherapy. Nevertheless, the reviewed studies varied widely in dosage, treatment duration, design, and sample size. The reported side effects are mostly mild; however, long-term studies are lacking to establish the complete safety of these treatments in children. Conclusions: Intranasal corticosteroids and oral montelukast effectively and safely manage adenoid hypertrophy and mild-to-moderate OSA symptoms in children. Nonetheless, the heterogeneity of study designs necessitates larger prospective trials with standardised protocols and more extended follow-up periods to draw more robust conclusions. Future studies should aim to stratify treatment outcomes based on OSA severity and duration to tailor therapeutic approaches better.

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Abstract There was a lack of high‐quality, evidence‐based treatment for lichen simplex chronicus (LSC). Topical steroid under hydrocolloid dressing treatment was investigated mostly in observational studies without investigation of the cost‐effectiveness and the methodology of application also varied without standardisation. To investigate the cost‐effectiveness of topical steroid under hydrocolloid dressing in the treatment of moderate to severe lichen simplex chronicus (LSC). The study aimed to provide a clear methodology that was replicable. A single‐blinded randomized controlled trial was carried out to compare the efficacy of 0.1% mometasone furoate cream with or without hydrocolloid dressing in patients suffering from moderate to severe LSC. Physician Global Assessment (PGA) score, Eczema Area and Severity Index (EASI) individual components score were assessed by a Dermatologist through clinical photos at week 0, 2, and 4. Pruritis Numerical Rating Scale (PNRS) was rated. Forty adult patients were recruited. The group with hydrocolloid dressing showed superior treatment efficacy. 20 out of 20 patients benefited from the hydrocolloid dressing with topical steroid while only 6 out of 20 patients benefited from topical steroid alone at week 2 regarding PGA. Similar result was obtained at week 4. Extra HK$ 132 was needed for each patient in hydrocolloid with topical steroid group. The number needed to treat (NNT) was 1.43 (95% CI: 1.42–1.44) at week 2 and 1.42 (95% CI: 1.41–1.44) at week 4 regarding PGA score improvement of ≥2. NNT analysis supported the cost‐effectiveness of adjunctive hydrocolloid dressing usage as the first‐line treatment in patients with moderate to severe LSC. This study added evidence to LSC treatment with a detailed and reproducible methodology.

Abstract licence: CC BY 4.0