Research
The MACRO Programme
The MACRO Trial is a randomised controlled trial (RCT) to produce evidence about the effectiveness and role of medical treatment (long-term antibiotics) and sinus surgery in adults with Chronic Rhinosinusitis (CRS) both with and without polyps. CRS is the major underlying cause of smell loss in the general population.
The MACRO Trial has now closed to recruitment. The project is now in the data analysis phase. A consensus meeting planned for March 2025 to agree recommendations based on the results.
The MACRO Programme Website
Are you affected by CRS and want to find out more about the project? Click here to visit the MACRO Programme Website
Fifth Sense has been involved with this National Institute of Health Research (NIHR)-funded trial since its application stage, with several of our Public and Patient Involvement (PPI) volunteers contributing their time in attending meetings, reviewing documentation and testing trial participant diaries and feedback forms.

Initial recruitment of patients into the trial of Workstream 2 began in December 2018. This covered the major clinical trial, comparing the outcomes for CRS patients who are randomly allocated to one of three different treatment groups. These treatments have all been used for CRS but no rigorous comparison of their relative effectiveness has been done before.
The first treatment group received the baseline treatment with nasal rinsing and a topical corticosteroid nasal spray and in addition a 12-week course of the antibiotic clarithromycin.
The second group received the same but with the clarithromycin substituted with a visually identical, but inactive pill – a placebo. Neither the patients nor the researchers working directly with the patients knew who was receiving which pill. This ensures that results collected by the researchers or reported by the patients are unbiased by any knowledge of the treatment. A third group of patients received the baseline treatment and also underwent endoscopic sinus surgery. A total of 600 patients participated in the trial, undergoing tests before treatment and at three and six months after, in order to measure the relative effectiveness of each.
Latest Progress
The project is now in Workstream 3. All the results are now being analysed and the team will make treatment recommendations based on their findings. The results will be published and disseminated to patients, GPs and specialists throughout the NHS.