Chronic Rhinosinusitis Clinical Trial
Chronic sinusitis is reported to be one of the most widespread disorders in the United
States. It can be caused by a variety of reasons such as allergy, infection and/or defects
in T-cells which help regulate immune function. Medication and other costs related to
treatment of nasal and sinus infections are estimated to be more than $60 million annually
putting a considerable strain on the economy of health care.
Probiotics are live microorganisms that are normally present in the gut of a healthy
individual. They are also known as "friendly bacteria" and have been used to help maintain
the normal functioning of the immune system. They are safe and are commercially available in
the form of yoghurt, sachets, chewable tablets or flavored capsules. Since a number of nasal
and sinus disorders are related to allergy and improper functioning of the immune system, we
hypothesize that regular use of probiotics may help improve chronic nasal and sinus symptoms
by boosting immune responses.
The project we propose is novel because it would be the first study evaluating the
usefulness of probiotics for the larger population having chronic sinusitis rather than
those having only allergic symptoms. We aim to assess whether regular use of probiotics will
help improve symptoms of chronic sinusitis and will have a greater effect than placebo in
this regard.
Probiotics are live microorganisms which when administered in adequate amounts confer a
health benefit on the host. They are a part of the normal gastrointestinal flora and have
safely been used to boost immune responses in patients with perennial and seasonal allergic
rhinitis. Their exact mechanism of benefit is unknown but they primarily help to regulate
T-cell function which is important in maintaining immune tolerance.
Chronic rhinosinusitis is widely prevalent and affects nearly 16 million people in the US
alone each year. It puts a strain on the health resources of the nation in terms of costs
related to medications and surgery. Chronic rhinosinusitis can be caused by a variety of
reasons including allergy/hypersensitivity, infection, nasal anatomical variations and
T-cell regulatory dysfunction. We hypothesize that regular use of probiotics in patients
with chronic rhinosinusitis will result in substantial improvement in their symptoms by
boosting their immunity and may also help decrease their medication usage.
Our study will be a double-blinded, randomized, control trial. We hope to recruit 100
patients from the University Otolaryngology and Allergy Clinics. Fifty patients will be
randomized to the treatment (active) arm and 50 patients to the placebo arm. Subjects will
be followed for 2 months during their period of participation in the study.
The main aim of our study is to determine whether regular use of probiotics in patients with
chronic rhinosinusitis helps improve their quality of life. Our main outcome of interest is
a change in the mean score of the Sino-Nasal Outcome Test (SNOT-20) form in the treatment
group and a greater change in the mean score of the SNOT-20 in the treatment arm as compared
to the placebo arm. If probiotics are found to be effective, they may be used as a
cost-effective, adjunctive therapy for patients with chronic rhinosinusitis.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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