Doxycycline or Oral Corticosteroids for Nasal Polyps

The study by Van Zele etal reports positive results for a randomized, double-blind, placebo-controlled trial that used either 20 days of doxycycline (200 mg the first day, followed by 100 mg daily) or 20 days of a tapering schedule of methyl prednisolone (32 mg on days 1-5, 16 mg on days 6-10, and 8 mg on days 11-20) for the treatment of nasal polyps. The primary end point was reduction in nasal polyp score which was graded 0 to 4 on each side, resulting in a score range of 0 to 8; the score was determined at baseline and weeks 1, 2, 4, 8, and 12. Entry criteria required that the patient either have recurrent polyps after surgery or massive polyps (grade 3 or 4); the total polyp score in each of the 3 groups averaged approximately 6. The patient population in this study was therefore at the severe end of the spectrum; results may not be generalizable to patients with milder disease.