Intranasal Lysine-Aspirin in Aspirin-Sensitive Nasal Polyposis: A Controlled Trial
Article first published online: 3 JAN 2009
Copyright © 2005 The Triological Society
Volume 115, Issue 8, pages 1385–1390, August 2005
How to Cite
Parikh, A. A. and Scadding, G. K. (2005), Intranasal Lysine-Aspirin in Aspirin-Sensitive Nasal Polyposis: A Controlled Trial. The Laryngoscope, 115: 1385–1390. doi: 10.1097/01.MLG.0000166702.38850.1B
- Issue published online: 3 JAN 2009
- Article first published online: 3 JAN 2009
- Manuscript Accepted: 6 APR 2005
- Nasal polyps;
- aspirin sensitivity;
- topical desensitisation;
- controlled trial
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.