A retrospective study on long-term efficacy of intranasal lysine-aspirin in controlling NSAID-exacerbated respiratory disease.

Abstract

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.

• Authors: Alfonso Luca Pendolino, Glenis K Scadding, Bruno Scarpa, Peter J Andrews
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 279 Issue 5 Pg. 2473-2484 (May 2022) ISSN: 1434-4726 [Electronic] Germany
• PMID: 34480600 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s).

Chemical References

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

Topics

• Administration, Intranasal
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Aspirin (adverse effects, analogs & derivatives)
• Humans
• Lysine (analogs & derivatives)
• Nasal Polyps (surgery)
• Respiration Disorders
• Retrospective Studies
• Sinusitis (surgery)