An open audit of montelukast, a leukotriene receptor antagonist, in nasal polyposis associated with asthma

Ragab, Sameh M.; Parikh, Abhi; Darby, Y.; Gk, Scadding

doi:10.1046/j.1365-2222.2001.01160.x

Cited by 112 publications

(83 citation statements)

References 37 publications

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“…They identified 5 such studies. Three were RCTs (level 1b), 1043,1046,1047 with 1 each of a nonrandomized, noncontrolled study (level 3) 1048 and a basic science study (level 5). 1049 Overall, they found moderate evidence of efficacy as an adjunctive treatment, used in conjunction with corticosteroids.…”

Section: Viiie9 Crswnp Management: Anti-lt Therapymentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

557

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Viiie9 Crswnp Management: Anti-lt Therapymentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

557

888

View full text Add to dashboard Cite

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“…Many patients require long-term oral glucocorticosteroids to achieve asthma control. Leucotriene receptor antagonists and synthesis inhibitors may also be of clinical benefit, although the magnitude of improvement after leucotriene antagonists did not seem to exceed that observed in ASA-tolerant patients (47). Management of chronic rhinosinusitis and nasal polyps (both medical and surgical if necessary) is essential, may be a prerequisite for the improvement of bronchial symptoms and should be conducted in close collaboration with the ENT specialist (22,48).…”

Section: Management Of a Patient With Aerdmentioning

confidence: 99%

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Kowalski

Makowska

Blanca³

et al. 2011

Allergy

393

366

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Following the first description of hypersensitivity reaction to aspirin (ASA) by Hirschberg in 1902, several types of hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) have been described. The NSAIDs-induced hypersensitivity reactions involve different mechanisms and present a wide range of clinical manifestations from anaphylaxis AbstractNonsteroidal anti-inflammatory drugs (NSAIDs) are responsible for 21-25% of reported adverse drug events which include immunological and nonimmunological hypersensitivity reactions. This study presents up-to-date information on pathomechanisms, clinical spectrum, diagnostic tools and management of hypersensitivity reactions to NSAIDs. Clinically, NSAID hypersensitivity is particularly manifested by bronchial asthma, rhinosinusitis, anaphylaxis or urticaria and variety of late cutaneous and organ-specific reactions. Diagnosis of hypersensitivity to a NSAID includes understanding of the underlying mechanism and is necessary for prevention and management. A stepwise approach to the diagnosis of hypersensitivity to NSAIDs is proposed, including clinical history, in vitro testing and/ or provocation test with a culprit or alternative drug depending on the type of the reaction. The diagnostic process should result in providing the patient with written information both on forbidden and on alternative drugs.

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“…Aspirin sensitivity was deduced from patients' histories and confirmed by lysine-aspirin nasal provocation, as previously described. 5 All patients also underwent skin prick tests with 10 common, inhaled allergens. Seven patients had positive reactions to house dust mite, pollen, grass, tree or cat antigens.…”

Section: Methodsmentioning

confidence: 99%

“…4 Our previous study, using the leukotriene D 4 receptor antagonist montelukast, confirmed the evidence that leukotrienes play an important role in the development of nasal polyps in patients with aspirin-intolerant asthma. 5 Trials of desensitisation, using aspirin, have been reported in patients with aspirin-intolerant asthma. Initially, the effect on asthma of oral desensitisation was examined.…”

Section: Introductionmentioning

confidence: 99%

Intranasal lysine-aspirin administration decreases polyp volume in patients with aspirin-intolerant asthma

Ogata

Darby

2007

J. Laryngol. Otol.

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Introduction: Nasal polyposis associated with aspirin-intolerant asthma tends to be difficult to control, with frequent recurrences. We examined the effect of intranasal lysine-aspirin administration on resistant nasal polyps of asthmatic, aspirin-intolerant patients, when used in addition to routine therapy.Patients and methods: Thirteen patients with asthma and intolerance to aspirin were recruited. All but one had undergone numerous polypectomies and were uncontrolled on standard therapy with intranasal corticosteroids, leukotriene receptor antagonists and nasal douching. Aspirin treatment involved one drop (100 ml) of 30 mg/ml lysine-aspirin solution to each nostril, initially daily, increased every two or three days up to a maximal of 18 drops (54 mg lysine-aspirin) a day. Nasal symptoms, nitric oxide level, nasal inspiratory peak flow rate, peak expiratory flow rate and nasendoscopic grading were assessed prior to therapy and three months later. We also compared the change in endoscopic polyp scores during three months of lysine-aspirin administration with the changes which had occurred during the three months prior to administration (during which time other therapies had been identical).Results: Nasal blockage symptoms tended to decrease; other nasal symptoms were unchanged. Significant changes were seen in nasal inspiratory peak flow rate (103.3 + 18.9 and 140.0 + 16.7 l/ min before and after aspirin, respectively; p ¼ 0.014), but not in peak expiratory flow rate (438.7 + 33.4 and 440.0 + 28.4 l/min before and after aspirin, respectively; p ¼ 0.700). Nasal nitric oxide levels rose significantly (in both sides, p ¼ 0.028). Expired chest nitric oxide levels did not change. Nasal polyp scores on nasendoscopic examination were significantly reduced (right side, p ¼ 0.027; left side, p ¼ 0.018). Compared with the preceding three months, adding intranasal lysine-aspirin application had the effect on decreasing nasal polyp volume (right side, p ¼ 0.031; left side, p ¼ 0.016).Conclusion: This open study suggests that intranasal lysine-aspirin administration reduces nasal polyp volume in aspirin-intolerant patients, without any adverse affect on concomitant asthma. This was a preliminary study and should be followed by a placebo-controlled, double-blind trial.

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An open audit of montelukast, a leukotriene receptor antagonist, in nasal polyposis associated with asthma

Abstract: The findings are consistent with a subgroup of nasal polyps/asthma patients in whom leukotriene receptor antagonists are effective. This is not related to aspirin sensitivity. Further placebo-controlled studies need to be undertaken.

Cited by 112 publications

References 37 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

Intranasal lysine-aspirin administration decreases polyp volume in patients with aspirin-intolerant asthma

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