Oral steroids and doxycycline: Two different approaches to treat nasal polyps Thibaut Van Zele, MD, PhD, Philippe Gevaert, MD, PhD, Gabriele Holtappels,

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Oral steroids and doxycycline: Two different approaches to treat nasal polyps Thibaut Van Zele, MD, PhD, Philippe Gevaert, MD, PhD, Gabriele Holtappels, Achim Beule, MD, Peter John Wormald, MD, Susanne Mayr, MD, Greet Hens, MD, PhD, Peter Hellings, MD, PhD, Fenna A. Ebbens, MD, PhD, Wytske Fokkens, MD, PhD, Paul Van Cauwenberge, MD, PhD, Claus Bachert, MD, PhD Journal of Allergy and Clinical Immunology Volume 125, Issue 5, Pages 1069-1076.e4 (May 2010) DOI: 10.1016/j.jaci.2010.02.020 Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Polyp size after treatment with methylprednisolone (solid circles) vs placebo (solid triangles) or doxycycline (solid squares) vs placebo. The mean changes from baseline were significantly different between the methylprednisolone and placebo groups (∗P < .05) and between the doxycycline and placebo groups (§P < .05). NPIF values were affected by methylprednisolone (solid circles) compared with placebo (solid triangles) and doxycycline (solid squares) compared with placebo. Area under the curve (AUC) values were calculated for methylprednisolone, doxycycline, and placebo, including negative peaks. Journal of Allergy and Clinical Immunology 2010 125, 1069-1076.e4DOI: (10.1016/j.jaci.2010.02.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Nasal symptoms after treatment with methylprednisolone (solid circles) vs placebo (solid triangles) or doxycycline (solid squares) vs placebo. The mean changes from baseline were significantly different between the methylprednisolone and placebo groups (∗P < .05) and between the doxycycline and placebo groups (§P < .05). Journal of Allergy and Clinical Immunology 2010 125, 1069-1076.e4DOI: (10.1016/j.jaci.2010.02.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Serum inflammatory parameters, blood eosinophilia, serum soluble IL-5Rα, and serum ECP levels after treatment with methylprednisolone (solid circles) vs placebo (solid triangles) or doxycycline (solid squares) vs placebo. The mean changes from baseline were significantly different between the methylprednisolone and placebo groups (∗P < .05) and between the doxycycline and placebo groups (§P < .05). MPO, Myeloperoxidase. Journal of Allergy and Clinical Immunology 2010 125, 1069-1076.e4DOI: (10.1016/j.jaci.2010.02.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Inflammatory markers in nasal secretions after treatment with methylprednisolone (solid circles) vs placebo (solid triangles) or doxycycline (solid squares) vs placebo. The mean changes from baseline were significantly different between the methylprednisolone and placebo groups (∗P < .05) and between the doxycycline and placebo groups (§P < .05). sol, Soluble. Journal of Allergy and Clinical Immunology 2010 125, 1069-1076.e4DOI: (10.1016/j.jaci.2010.02.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Study design. At visit 1, randomized allocation to 1 of the 3 treatment groups took place. Follow-up visits were scheduled at 1, 2, 4, 8, and 12 weeks after randomization. Journal of Allergy and Clinical Immunology 2010 125, 1069-1076.e4DOI: (10.1016/j.jaci.2010.02.020) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions