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糠酸莫米松鼻窦植入物——治疗复发性鼻息肉病的新靶向方法。

Mometasone furoate sinus implant - a new targeted approach to treating recurrent nasal polyp disease.

机构信息

a Feinberg School of Medicine, Department of Otolaryngology - Head and Neck Surgery , Northwestern University , Chicago , IL , USA.

出版信息

Expert Rev Clin Pharmacol. 2018 Dec;11(12):1163-1170. doi: 10.1080/17512433.2018.1549485. Epub 2018 Dec 4.

Abstract

: Chronic rhinosinusitis (CRS) is a broad heterogeneous inflammatory disorder of the nose and paranasal sinuses, resulting from the dysfunctional interplay between host immunity, defective epithelial barrier, and environmental factors. CRS with nasal polyps (CRSwNP) is considered a more severe clinical phenotype with greater burden of symptoms and higher relapse rate, especially with comorbid asthma or aspirin sensitivity. Available treatment options after endoscopic sinus surgery (ESS) - systemic corticosteroids or revision surgery - have significant risks and limitations. : Bioabsorbable, steroid-eluting implants have been studied extensively for the ability to dilate and re-establish sinus patency by the localized, controlled delivery of topical corticosteroids to diseased sinonasal lining and nasal polyps. This review provides a comprehensive, up to date analysis of the literature regarding a novel, office-based, mometasone furoate (MF) sinus implant that may treat patients with recurrent CRSwNP after ESS. : Clinical evidence has demonstrated the safety and efficacy of steroid-eluting implant in the reduction of polyp size, symptom burden, and the need for revision sinus surgery. MF sinus implants may play an important role in the management of patients with recurrent polyposis after sinus surgery.

摘要

慢性鼻-鼻窦炎(CRS)是一种广泛存在的异质性鼻腔和鼻窦炎症性疾病,是宿主免疫功能障碍、上皮屏障功能缺陷和环境因素相互作用的结果。伴有鼻息肉的 CRS(CRSwNP)被认为是一种更为严重的临床表型,其症状负担更重,复发率更高,尤其是合并哮喘或阿司匹林敏感性时。内镜鼻窦手术(ESS)后可选择的治疗方案——全身皮质类固醇或修正手术——存在显著的风险和局限性。

生物可吸收、载皮质类固醇的植入物已被广泛研究,其通过局部、控制地向患病的鼻腔和鼻窦衬里及鼻息肉输送局部皮质类固醇,具有扩张和重新建立鼻窦通畅的能力。本综述全面、最新地分析了一种新型的、基于办公室的糠酸莫米松(MF)鼻窦植入物的文献,该植入物可能对 ESS 后复发性 CRSwNP 患者有效。

临床证据表明,载皮质类固醇植入物在减少息肉大小、症状负担和修正鼻窦手术需求方面是安全有效的。MF 鼻窦植入物可能在鼻窦手术后复发性息肉患者的治疗中发挥重要作用。

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