Postoperative Systemic Corticosteroids When Utilizing a Steroid-Eluting Spacer Following Endoscopic Sinus Surgery

NCT ID: NCT01564355

Last Updated: 2014-12-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-30

Study Completion Date

2013-12-31

Brief Summary

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Chronic rhinosinusitis (CRS) is an inflammatory condition of the nose and sinuses. It affects about 5 to 10% of Canadians. Patients suffer from congestion in the nose and sinuses, nasal discharge, pressure in the face, and a reduced sense of smell. This affects people's enjoyment of life. Medical management uses sprays or pills to treat these symptoms but for some patients sinus surgery is needed. This type of surgery is called endoscopic sinus surgery (ESS).

There is no single correct approach to take care of patients after sinus surgery. Most experts would use a nasal spray and a short-course of oral steroid pills to reduce sinus swelling and minimize complications related to scarring.

"Steroid-eluting nasal spacers" are devices placed inside the sinus during surgery and slowly release topical steroids into the sinuses better than steroid sprays. These "spacers" have been shown to improve results following sinus surgery. When using these special "spacers", there may no longer be a need for oral steroid pills following surgery. This would help to avoid potential side effects associated with these medications.

The purpose of this study is to find out whether taking oral (systemic) steroid pills following sinus surgery is necessary to improve surgical results, now that steroid-eluting nasal spacers are commonly used during surgery.

Detailed Description

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Conditions

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Chronic Sinusitis Endoscopic Sinus Surgery Post-operative Care Steroids Drug-eluting Spacer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Systemic Steroid Group

Will receive post-operative oral steroids for 10 days as per usual protocol.

Group Type EXPERIMENTAL

Steroid-eluting middle meatal spacer (Nasopore (TM) spacer impregnated with 1 cc of 40mg/mL triamcinolone liquid)

Intervention Type DEVICE

All study arms will receive bilateral Nasopore spacers impregnated with 1 cc of Triamcinolone to remain in the nasal cavity for 1 week post-operatively as per usual protocol.

Post-op Oral Steroids

Intervention Type DRUG

Post-operative oral prednisone 20 mg QD x 5 days , then 10 mg x 5 days, as per usual protocol.

Placebo

Will receive placebo pills for 10 days post-operatively

Group Type PLACEBO_COMPARATOR

Steroid-eluting middle meatal spacer (Nasopore (TM) spacer impregnated with 1 cc of 40mg/mL triamcinolone liquid)

Intervention Type DEVICE

All study arms will receive bilateral Nasopore spacers impregnated with 1 cc of Triamcinolone to remain in the nasal cavity for 1 week post-operatively as per usual protocol.

Interventions

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Steroid-eluting middle meatal spacer (Nasopore (TM) spacer impregnated with 1 cc of 40mg/mL triamcinolone liquid)

All study arms will receive bilateral Nasopore spacers impregnated with 1 cc of Triamcinolone to remain in the nasal cavity for 1 week post-operatively as per usual protocol.

Intervention Type DEVICE

Post-op Oral Steroids

Post-operative oral prednisone 20 mg QD x 5 days , then 10 mg x 5 days, as per usual protocol.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adult ( \> 18 years of age)
* CRS defined by 2007 Adult Sinusitis Guidelines19
* Electing endoscopic sinus surgery for the indication medically refractory CRS, as defined by having persistent symptoms despite the following "maximal medical therapy":

1. Received 3 months of topical corticosteroid spray
2. Received a 2 week course of a broad-spectrum antibiotic combined with a 2 week course of systemic corticosteroid
* Provide written informed consent
* Subject must be able to complete all study evaluations and HRQoL questionnaires written in English

Exclusion Criteria

* Children (\< 18 years of age)
* Unable to complete questionnaires or clinical testing or cooperate with study evaluations in English.
* Unwilling to provide written, informed consent
* Patients who have not undergone previous "maximum" prescribed medical therapy
* Patients with suspected systemic inflammatory disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Calgary

OTHER

Sponsor Role lead

Responsible Party

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Dr. Luke Rudmik

Clinical Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Richmond Road Diagnostic and Treatment Centre

Calgary, Alberta, Canada

Site Status

Countries

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Canada

References

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Dautremont JF, Mechor B, Rudmik L. The role of immediate postoperative systemic corticosteroids when utilizing a steroid-eluting spacer following sinus surgery. Otolaryngol Head Neck Surg. 2014 Apr;150(4):689-95. doi: 10.1177/0194599814521373. Epub 2014 Jan 30.

Reference Type DERIVED
PMID: 24482348 (View on PubMed)

Other Identifiers

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24336

Identifier Type: -

Identifier Source: org_study_id