Use of Doxycycline to improve anosmia and quality of life in CRSwNP patients

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Created On: 08/05/2023

A randomized, double-blind, placebo-controlled study was conducted to assess the effectiveness of Doxycycline in chronic rhinosinusitis with nasal polyps (CRSwNP) patients.

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Key take away

Doxycycline effectively improves the quality of life and anosmia in CRSwNP-affected people.

Background

A randomized, double-blind, placebo-controlled study was conducted to assess the effectiveness of Doxycycline in chronic rhinosinusitis with nasal polyps (CRSwNP) patients.

Method

Overall, 100 subjects were divided into two groups at random and given either Doxycycline (200 mg on the first day, followed by 100 mg every day) or a placebo for six weeks. Throughout the trial, nasal irrigation, Montelukast, and Fluticasone were given to every patient as baseline treatments.

The quality of life as measured by the sino-nasal outcome test (SNOT-22) questionnaire was the major endpoint ascertained. By using a visual analogue scale (VAS), the peak nasal inspiratory flow (PNIF) and the symptom severity were assessed. The Lund-Mackay score based on low dose paranasal computed tomography scan, eosinophil in nasal secretions, serum immunoglobulin E (IgE) level, and baseline blood eosinophil count were also noted.

Result

Doxycycline therapy boosted SNOT-22 and olfactory function. The baseline SNOT-22 score had no impact on the results. Doxycycline had a similar impact on patient's quality of life whether they had nasal eosinophilia or not. Moreover, there was no association between the alteration in SNOT-22 score and the eosinophil count (r = -0.198) or serum IgE (r = -0.186).

Conclusion

Doxycycline is promising to enhance the quality of life in people with CRSwNP. Moreover, it has short-term benefits for the sense of smell. The response to therapy is unaffected by the levels of eosinophil in the blood and nasal secretions. Doxycycline can therefore be utilized to combat nasal polyps that are eosinophilic and non-eosinophilic.