Overview

• Findings published in The Lancet show endoscopic sinus surgery delivered sustained symptom relief at six months in the MACRO randomized trial.
• More than 500 UK adults were assigned to surgery, a three‑month course of clarithromycin, or placebo, with all receiving nasal steroids and saline rinses.
• Clarithromycin offered no benefit over placebo, while 87% of those who had surgery reported improved quality of life at six months.
• Patient-reported symptom scores improved by roughly 30 points after surgery versus about 10 points with clarithromycin or placebo.
• Investigators are conducting cost-effectiveness analyses and longer-term follow-up to inform NHS referral and access decisions, and they note that generalizability to patients without nasal polyps needs further study.