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FDA Guidance on Sinusitis and Its Potential Impact on Treatment

by Bradley F. Marple, MD • April 1, 2008

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The FDA responded, in turn, with the announcement of a proposed draft guidance in November 2006, titled Sinusitis: Designing Clinical Development Programs of Nonantimicrobial Drugs for Treatment. In this document, chronic sinusitis is defined as an inflammation of the sinuses …when duration is longer than 8 weeks.9 As with many of the opposing points of view that were earlier argued, the main points of difference were those of nomenclature and duration of therapy. Rebuttals were submitted by several sources, the draft guidance, however, was posted with no changes made in the definition.10

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April 2008

Although the definition offered by the FDA for chronic sinusitis differs somewhat from that originally developed by the Task Force on Chronic Rhinosinusitis, the issue that is most relevant to the standardized drug development is the endorsement of a definition by the FDA that is based on the inflammatory response that is common to the disease. This constitutes the next step in establishing the collaborations necessary for medical treatment development, and will hopefully usher in a new era of concept development, testing, and implementation of therapies for CRS that are held to the same efficacy and safety standards common to FDA-approved interventions.

References

  1. Meltzer EO, Hamilos DL, Hadley JA, et al. Establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg 2004;131(6)Suppl 1:S1-S62.
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  2. Benninger MS, Ferguson BJ, Hadley JA, et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003;129(3)Suppl 1:S1-S32.
    [Context Link]
  3. Benninger MS, Holzer SE, Lau J. Diagnosis and treatment of uncomplicated acute bacterial rhinosinusitis: Summary of the Agency for Health Care Policy and Research evidence-based report. Otolaryngol Head Neck Surg 2000;122:1-7.
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  4. Gliklich RE, Metson R. The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg 1995;113:104-9.
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  5. Subramanian HN, Schectman KB, Hamilos DL. A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am J Rhinol 2002;16:303-12.
    [Context Link]
  6. Dubin MG, Liu C, Lin SY, Senior BA. American Rhinologic Society member survey on maximal medical therapy for chronic rhinosinusitis. Am J Rhinol 2007;21(4):483-8.
    [Context Link]
  7. Valera FC, Anselmo-Lima WT. Evaluation of efficacy of topical corticosteroid for the clinical treatment of nasal polyposis: searching for clinical events that may predict response to treatment. Rhinology 2007;45(1):59-62.
    [Context Link]
  8. Orlandi RR, Marple BF. Development and evaluation of new technologies in otolaryngology-head and neck surgery. Otolaryngol Head Neck Surg 2007;137(4):529-31.
    [Context Link]
  9. www.fda.gov/cder/guidance/7316dft.pdf.
    [Context Link]
  10. www.fda.gov/ohrms/dockets/dockets/06d0463/06d-0463-c000001-01-vol1.pdf.
    [Context Link]

©2008 The Triological Society

Pages: 1 2 3 4 5 | Single Page

Filed Under: Departments, Health Policy, Medical Education, Practice Focus, Rhinology Tagged With: guidelines, healthcare reform, medication, outcomes, patient safety, policy, research, rhinosinusitis, Sinusitis, steroids, treatmentIssue: April 2008

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