Intranasal lysine-aspirin in aspirin-sensitive nasal polyposis: a controlled trial.

Abstract

OBJECTIVES/HYPOTHESIS:

Intranasal lysine-aspirin has been used as a method of desensitization in patients with aspirin-sensitive nasal polyps to control their recurrence and prevent frequent surgical intervention. However, the studies are limited in number, and their design is open to criticisms. Thus, we conducted a controlled trial to study the clinical effectiveness of topical lysine-aspirin in patients with aspirin-sensitive nasal polyposis.

STUDY DESIGN:

Prospective, randomized, double blind, placebo controlled, crossover trial.

METHODS:

Aspirin-sensitive patients confirmed by intranasal challenge were enrolled and randomized to receive 16 mg of topical lysine-aspirin every 48 hours or placebo for 6 months before crossover. Polyp growth and nasal and chest symptoms were monitored using acoustic rhinometry, nasal inspiratory peak flow, peak expiratory flow rate, and a daily diary of symptom scores.

RESULTS:

Twenty-two patients were enrolled. After withdrawals and drop outs, data were available on 11 patients for analysis. Multivariate analysis of measured parameters did not reveal a significant clinical benefit to patients receiving topical lysine-aspirin compared with placebo. Deterioration was similar while on lysine-aspirin or placebo.

CONCLUSIONS:

This is the first controlled clinical trial of topical desensitization in aspirin-sensitive nasal polyp patients. Despite the failure to demonstrate clinical benefit, tissue studies have shown a significant improvement at the microscopic level. Further work with larger numbers of patients along with conventional treatment may show a clinical improvement in these patients.

• Authors: Abhi A Parikh, Glenis K Scadding
• Journal: The Laryngoscope (Laryngoscope) Vol. 115 Issue 8 Pg. 1385-90 (Aug 2005) ISSN: 0023-852X [Print] United States
• PMID: 16094110 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Lysine
• Aspirin
• acetylsalicylic acid lysinate

Topics

• Administration, Intranasal
• Adult
• Age Factors
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
• Aspirin (administration & dosage, analogs & derivatives)
• Cross-Over Studies
• Dose-Response Relationship, Drug
• Double-Blind Method
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Humans
• Lysine (administration & dosage, analogs & derivatives)
• Male
• Middle Aged
• Multivariate Analysis
• Nasal Polyps (drug therapy, pathology)
• Nasal Provocation Tests
• Probability
• Risk Factors
• Sex Factors
• Statistics, Nonparametric
• Treatment Outcome