Is Verapamil Effective for Treating Patients With Chronic Rhinosinusitis With Nasal Polyps? A Systematic Review.

OBJECTIVE

Identify and summarise the evidence on the efficacy of low-dose verapamil use for adult patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP).

METHODS

Two reviewers independently searched the data sources until the 28th of December 2023. From 262 studies identified, PRISMA guidelines were implemented to include three randomised controlled trials that used verapamil for patients diagnosed with CRSwNP. Primary endpoints were extracted, including quality-of-life questionnaires and imaging gradings.

RESULTS

Across 116 participants, all three studies showed statistically significant improvement in the subjective scores of patients who experienced symptoms in the verapamil group. The mean differences between the two intervention groups and placebo in SNOT-22 were -19.17 (95% CI: -30.76 to -7.58) and -27.7 (95% CI: -49.36 to -6.05). On the objective metrics, statistically significant improvement in TNPS or LMS between groups was seen in two out of the three studies (0.01 [p = 0.001], -5.2 [p = 0.02]).

CONCLUSION

Although verapamil usage resulted in significant improvements in the subjective and objective measurements of the severity of CRSwNP, the current evidence is insufficient to support widespread usage of verapamil for CRSwNP. Further studies should focus on recruiting a clinically significant number of patients, while ensuring robustness and homogeneity in the methodological design.