Low-dose Methotrexate (MTX) is efficacious and has a favorable safety profile in patients suffering from recurrent chronic rhinosinusitis and nasal polyps (CRSwNPs), according to an open-label, randomized, controlled, phase 2 clinical study. In order to treat recurring postoperative CRSwNPs, researchers assessed the effectiveness and safety of low-dose MTX.

A total of 41 CRSwNPs-affected subjects who had postoperative polyp recurrences were randomly assigned to one of three groups for eight weeks: (a) Once weekly oral 10 mg MTX (MTX arm, n = 14), (b) Daily oral Methylprednisolone 8 mg (oral corticosteroids [OCS] arm, n = 14), and (c) Daily intranasal Mometasone Furoate Monohydrate 200 mcg (control [intranasal corticosteroids (INCS)] arm, n = 13).

The adverse events, serum biochemical assays, presence of peripheral eosinophilia, serum total IgE level, butanol olfactory threshold test (BuOT), peak nasal inspiratory flow (PNIF), Turkish Sinonasal Outcome Test-22 (SNOT-22), visual analogue scale (VAS), and Lund-Kennedy endoscopic grading system (LKES) were all used to evaluate participants over the course of three clinical visits. With the exception of the nonrecovery of the INCS group's peripheral eosinophilia, all effectiveness outcome measures were considerably enhanced in all the 3 groups.

In terms of LKES scores, there was no profound difference among the groups. The scores for the Turkish versions of PNIF, BuOT, SNOT-22, and serum immunoglobulin E levels, were comparable among the groups. Contrasted to the MTX group, the total VAS ratings recovered much more quickly in the INCS group. All groups' serum biochemical tests remained normal. Adverse events noted were minor and only present in the OCS group. Hence, low-dose MTX was found to be a promising option for the management of recurrent postoperative CRSwNPs.