Comparing the efficiency of beclomethasone, fluticasone and mometasone nasal sprays in a Samter's population

Master Thesis

2015

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University of Cape Town

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Statement of problem: Topical corticosteroids nasal sprays remain first line of treatment for patients with chronic rhinosinusitis (with or without nasal polyps). The main aim of treatment is to improve nasal symptoms by reducing or eliminating the nasal polyps and preventing polyp recurrence post-operatively. Our aims were to determine if the type of corticosteroid nasal spray used post operatively influences polyp recurrence rate and if there were any subsequent economic implications as we only have beclomethasone available for prescription in our state hospital. Methods: Retrospective case note review of all Samter's patients who underwent fronto-spheno-ethmoidectomy by a single surgeon (2000 – 2014). Results: 58 patients were included in our study, divided into 3 study groups. When compared to patients using beclomethasone; patients using fluticasone had an 80% reduced risk of polyp recurrence and patients using mometasone a 90% reduced risk. This rose to 88% and 96% respectively when adjusted for age. Conclusion: Fluticasone and mometasone are both statistically significantly more effective at reducing polyp recurrence than beclomethasone in our population group. Mometasone appeared more effective than fluticasone, but this difference was not statistically significant.
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