A comprehensive study led by University Medicine Halle in Germany, involving more than 300 patients, has revealed surprising findings about the treatment of sudden hearing loss.
Published in NEJM Evidence, the study challenges the effectiveness of high-dose glucocorticoid therapy, a common treatment approach for this condition.
Sudden hearing loss affects hundreds of thousands of people globally each year and is typically treated with anti-inflammatory drugs like glucocorticoids, similar to cortisone.
The prevailing belief was that a high systemic dose of these drugs, administered over a short period, might be more effective than standard treatment.
However, this large-scale randomized controlled trial, the most extensive of its kind, aimed to systematically evaluate and compare the impacts of different glucocorticoid treatment strategies.
The trial involved 325 patients across 39 sites in Germany, divided into three groups. While one group received standard treatment, the other two were given significantly higher doses of either the same drug or a similar one.
The researchers then assessed the extent of hearing improvement after 30 days and noted any side effects.
Professor Stefan Plontke, the coordinating investigator of the trial and director of the Department of Otorhinolaryngology, Head and Neck Surgery at University Medicine Halle, reported that the higher doses did not yield better outcomes than the standard therapy.
Moreover, adverse events, such as elevated blood sugar levels and increased blood pressure in patients with pre-existing hypertension, were more common in the high-dose groups.
Remarkably, the majority of patients across all groups did not experience complete symptom relief, despite immediate glucocorticoid treatment.
Even in the standard therapy group, which showed the best results, about 60% of patients had not fully recovered after 30 days.
For 50 years, glucocorticoids have been the global standard of care for sudden hearing loss, but their true effectiveness in treating idiopathic sudden sensorineural hearing loss remains uncertain.
Plontke suggests that further research is needed to compare the effectiveness of glucocorticoids with a placebo.
He emphasizes the growing need for new drug treatment options for sudden hearing loss, given the current uncertainties in treatment efficacy.
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The research findings can be found in NEJM Evidence.
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