(A244) The Efficacy of Probiotics in the Management of Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

Introduction: Chronic rhinosinusitis (CRS) is a multifactorial inflammatory condition that affects approximately 12% of the global population and significantly impairs the quality of life. This study aims to evaluate the efficacy of probiotics as adjunctive therapy for CRS management compared to placebo treatment.

Methods: A systematic review and meta-analysis were conducted from November 2024 to January 2025 to assess the role of probiotics in CRS treatment. A systematic review was conducted using PubMed, Cochrane, and Embase databases. Studies were included if they examined probiotics' impact on CRS symptoms (SNOT-22 scores) and inflammatory markers (IL-6, TNF-α). Eligible RCTs included adult CRS patients treated with probiotics strains compared to placebo. Outcomes entailed changes in symptom severity (SNOT-22 scores) and inflammatory markers (IL-6 and TNF-α levels). Study quality was assessed using the Cochrane Risk of Bias tool. A meta-analysis was conducted using a random-effects model and heterogeneity was assessed with I² statistics.

Results: Probiotics demonstrated a significant reduction in SNOT-22 scores (mean difference: - 8.3 points; 95% CI: -11.1 to -5.5; p < 0.001) and IL-6 levels (mean difference: -1.4 pg/mL; 95% CI: -1.5 to -0.9; p < 0.01). No significant effect was observed for TNF-α (mean difference: -0.2 pg/mL; 95% CI: -0.6 to 0.2; p = 0.21). Heterogeneity was moderate for SNOT-22 (I² = 38%) and IL-6 (I² = 42%).

Conclusions: Probiotics demonstrate significant potential as adjunctive treatment for CRS by improving symptom severity and reducing inflammation. These findings highlight the need for standardized probiotic regimens and additional large-scale studies to optimize long-term efficacy and safety.