Assessment of efficacy and safety of the herbal medicinal product BNO 1016 in chronic rhinosinusitis.

Rhinology. 2017 Jun 1;55(2):142-151. doi: 10.4193/Rhin16.103. Palm J1, Steiner I2, Abramov-Sommariva D3, Ammendola A3, Mitzenheim S3, Steindl H3, Wonnemann M3, Bachert C4. Author information 1 Rothenbach, Germany. 2 Posnan, Poland. 3 Bionorica SE, Neumarkt, Germany. 4 Ghent University Hospital, Ghent, Belgium. Abstract BACKGROUND: The objective of this clinical trial (CRS-02) was to assess the efficacy, safety and tolerability of two dosages of the herbal medicinal product BNO 1016 (Sinupret extract) in patients with chronic rhinosinusitis (CRS). METHODOLOGY: 929 patients suffering from CRS were enrolled in this randomised placebo-controlled trial with a treatment period of 12 weeks. The primary endpoint was the mean Major Symptom Score (MSS) in week 8 and week 12 compared to placebo. Secondary endpoints included further MSS related parameters and responder rates over time. Pharmacoeconomic endpoints were also analysed. Finally, safety and tolerability were evaluated. RESULTS: Sinupret extract was not superior over placebo regarding the primary endpoint. However, the results of the secondary endpoints showed a clear trend towards superior efficacy. Therefore, additional post-hoc sensitivity analyses were performed in patients with a baseline MSS over 9 and persistence of disease more than 1 year diagnosed by specialists in otorhinolaryngology. Those patients significantly benefited from Sinupret extract. Therapy was superior for the primary endpoint analysis. Patients were less impaired with respect to work and daily activities. A good safety and tolerability of Sinupret extract was assured in all patients. CONCLUSIONS: Sinupret extract can safely be administered in patients with CRS. Although the primary endpoint of the study was not significant, a post-hoc subgroup analysis in patients whose disease was diagnosed by a specialist revealed a pronounced treatment effect. Effects in that subgroup were even stronger with longer disease persistence and stronger severity. PMID: 28214913 DOI: 10.4193/Rhin16.103