Mount Sinai Hospital System, New York, NY.
Ascension St. Vincent Anderson, Anderson, IN.
Int Forum Allergy Rhinol. 2022 Jan;12(1):51-61. doi: 10.1002/alr.22868. Epub 2021 Aug 6.
The purpose of this study was to test whether cryotherapy is superior to a sham procedure for reducing symptoms of chronic rhinitis.
This study was a prospective, multicenter, 1:1 randomized, sham-controlled, patient-blinded trial. The predetermined sample size was 61 participants per arm. Adults with moderate/severe symptoms of chronic rhinitis who were candidates for cryotherapy under local anesthesia were enrolled. Participants were required to have minimum reflective Total Nasal Symptom Scores (rTNSSs) of 4 for total, 2 for rhinorrhea, and 1 for nasal congestion. Follow-up visits occurred at 30 and 90 days postprocedure. Patient-reported outcome measures included the rTNSS, standardized Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ(S)], and Nasal Obstruction Symptom Evaluation (NOSE) questionnaires. Adverse events were also recorded. The primary endpoint was the comparison between the treatment and sham arms for the percentage of responders at 90 days. Responders were defined as participants with a 30% or greater reduction in rTNSS relative to baseline.
Twelve US investigational centers enrolled 133 participants. The primary endpoint analysis included 127 participants (64 active, 63 sham) with 90-day results. The treatment arm was superior at the 90-day follow-up with 73.4% (47 of 64) responders compared with 36.5% (23 of 63) in the sham arm (p < 0.001). There were greater improvements in the rTNSS, RQLQ(S), and NOSE scores for the active arm over the sham arm at the 90-day follow-up (p < 0.001). One serious procedure-related adverse event of anxiety/panic attack was reported.
Cryotherapy is superior to a sham procedure for improving chronic rhinitis symptoms and patient quality of life.
本研究旨在检验冷冻疗法是否优于假手术,以减轻慢性鼻炎症状。
本研究为前瞻性、多中心、1:1 随机、假手术对照、患者盲法试验。预定的样本量为每组 61 例。纳入接受局部麻醉下冷冻治疗的中重度慢性鼻炎症状成人患者。患者需满足总反射性鼻症状评分(rTNSS)总分≥4 分、鼻漏≥2 分和鼻塞≥1 分。术后 30 和 90 天进行随访。患者报告结局测量包括 rTNSS、标准化鼻结膜炎生活质量问卷(RQLQ[S])和鼻腔阻塞症状评估(NOSE)问卷。还记录了不良事件。主要终点是治疗组和假手术组在 90 天的应答率比较。应答者定义为 rTNSS 相对于基线降低 30%或以上的患者。
12 家美国研究中心共纳入 133 例患者。主要终点分析包括 127 例患者(治疗组 64 例,假手术组 63 例)的 90 天结果。治疗组在 90 天随访时应答率为 73.4%(64 例中的 47 例),假手术组为 36.5%(63 例中的 23 例),治疗组显著高于假手术组(p<0.001)。治疗组在 rTNSS、RQLQ[S]和 NOSE 评分方面的改善在 90 天随访时显著优于假手术组(p<0.001)。报告了 1 例与手术相关的严重不良事件(焦虑/惊恐发作)。
冷冻疗法在改善慢性鼻炎症状和患者生活质量方面优于假手术。