| Title: |
A retrospective study on long-term efficacy of intranasal lysine-aspirin in controlling NSAID-exacerbated respiratory disease |
| Authors: |
Pendolino, AL; Scadding, GK; Scarpa, B; Andrews, PJ |
| Source: |
European Archives of Oto-Rhino-Laryngology (2021) (In press). |
| Publisher Information: |
SPRINGER |
| Publication Year: |
2021 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Otorhinolaryngology; Anti-inflammatory agents non-steroidal; Asthma; Aspirin-induced; Nasal polyps; Smell; Aspirin; NASAL POLYPOSIS; DESENSITIZATION-TREATMENT; CHRONIC RHINOSINUSITIS; ACETYLSALICYLATE; CHALLENGE |
| Description: |
Purpose: Aspirin treatment after desensitization (ATAD) represents an effective therapeutic option suitable for NSAID-exacerbated respiratory disease (N-ERD) patients with recalcitrant disease. Intranasal administration of lysine-aspirin (LAS) has been suggested as a safer and faster route than oral ATAD but evidence for its use is less strong. We investigated nasal LAS therapy long-term efficacy based on objective outcomes, smell function, polyp recurrence and need for surgery or rescue therapy. Clinical biomarkers predicting response to intranasal LAS, long-term side effects and consequences of discontinuing treatment have been evaluated. Methods: A retrospective analysis of a database of 60 N-ERD patients seen between 2012 and 2020 was performed in March 2021. They were followed up at 3-months, 1-, 2- and 3-years with upper and lower airway functions assessed at each follow-up. Results: Higher nasal airflow and smell scores were found at each follow-up in patients taking LAS (p < 0.001 and p=0.048 respectively). No influence of LAS on pulmonary function measurements was observed. Patient on intranasal LAS showed a lower rate of revision sinus surgery when compared to those who discontinued the treatment (p < 0.001). None of the variables studied was found to influence LAS treatment response. Conclusion: Our study demonstrates the clinical effectiveness of long-term intranasal LAS in the management of N-ERD in terms of improved nasal airflow and olfaction and a reduced need for revision sinus surgery. Intranasal LAS is safe, being associated with a lower rate of side effects when compared to oral ATAD. However, discontinuation of the treatment at any stage is associated with a loss of clinical benefit. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10136176/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10136176/1/Pendolino2021_Article_ARetrospectiveStudyOnLong-term.pdf; https://discovery.ucl.ac.uk/id/eprint/10136176/ |
| Rights: |
open |
| Accession Number: |
edsbas.50AA18C7 |
| Database: |
BASE |