Intranasal corticosteroids
Topical anti-inflammatory
- Response rate
- Modest polyp reduction
- Onset
- Weeks–months
- Route
- Intranasal daily (mometasone, fluticasone, budesonide)
- Line
- 1st
- IgM effect
- Modest polyp reduction
Evidence summary
First-line medical therapy for all CRSwNP patients. Suppress local inflammation and can modestly reduce polyp size. Most effective as maintenance therapy after surgery or alongside biologics. Budesonide rinses may provide better sinus distribution than sprays.