Intranasal Lysine-Aspirin in Aspirin-Sensitive Nasal Polyposis: A Controlled Trial

Authors

  • Abhi A. Parikh MS, FRCS(ORL-HNS),

    Corresponding author
    1. St. Mary's Hospital, London, UK and the Royal National Throat, Nose and Ear Hospital, London, UK.
    • Mr. Abhi A. Parikh, Consultant Otolaryngologist, St. Mary's Hospital, Praed Street, London W2 1NY, United Kingdom.
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  • Glenis K. Scadding MD, FRCP

    1. St. Mary's Hospital, London, UK and the Royal National Throat, Nose and Ear Hospital, London, UK.
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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.1 Further work with larger numbers of patients along with conventional treatment may show a clinical improvement in these patients.

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