Symptomatic treatment of rhinosinusitis: a choice based on evidence-based medicine | Ukrainian Medical Journal

Rhinosinusitis is a common manifestation of seasonal respiratory infections and requires effective symptomatic treatment. According to EPOS-2020, standardized myrtol (ELOM-080) and BNO 1016 may be used for the symptomatic management of acute rhinosinusitis. This paper presents a comparative analysis of the current evidence base for these herbal preparations. Both agents have a standardized composition and clinical evidence of efficacy; however, they differ in their mechanisms of action and the strength of supporting evidence. ELOM-080 (Respero Myrtol) directly affects mucociliary clearance, combining mucokinetic, secretolytic, and anti-inflammatory effects. In contrast, BNO 1016 (Sinupret^®) is characterized primarily by secretolytic and anti-inflammatory activity. ELOM-080 has several advantages in terms of evidence: a recently conducted large randomized clinical trial, results of a direct comparative study with BNO 1016, and clinical data regarding its use in COVID-19. In contrast, the recent evidence for BNO 1016 mainly consists of meta-analyses of previously conducted randomized trials, while clinical data on its use in COVID-19 are lacking. Thus, although both agents may be used for the symptomatic treatment of rhinosinusitis, the available evidence suggests that ELOM-080 has a more pathophysiologically grounded mechanism of action and a more robust evidence base, allowing it to be considered an optimal herbal option for symptomatic treatment of rhinosinusitis.

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