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Wednesday, November 28, 2018

Antileukotrienes improve naso-ocular symptoms and biomarkers in patients with NARES and asthma.

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Antileukotrienes improve naso-ocular symptoms and biomarkers in patients with NARES and asthma.

Laryngoscope. 2018 Nov 26;:

Authors: De Corso E, Anzivino R, Galli J, Baroni S, Di Nardo W, De Vita C, Salvati A, Autilio C, Settimi S, Mele D, Paludetti G, Mullol J

Abstract
OBJECTIVE: The aim of our study was to analyze the montelukast effectiveness in improving oculonasal symptoms, patient-reported outcomes (PROs), and eosinophilic biomarkers in patients with nonallergic rhinitis eosinophilic syndrome (NARES).
METHODS: We enrolled prospectively 80 symptomatic patients treated with 10 mg once a day of montelukast in monotherapy for 2 months. All patients were investigated before and after treatment. Nasal symptoms (nasal obstruction, rhinorrhoea, sneezing, nasal itching), ocular symptoms (redness/puffiness, watery eyes), and other PROs (olfactory dysfunction, difficulty going to sleep, nighttime awakenings, and nasal congestion on awakening) were scored by visual analogic scale. The following clinical scores were assessed: Total Nasal Symptom Score (T4NSS), Total Ocular Symptom Score (T2OSS), Total Symptom Score of Patient-Reported Outcomes (TSS-PROs), and a Composite Symptoms Score (CSS). Patients were classified as responders when a reduction of at least 50% of the CSS was observed. Before and after treatment, the eosinophilic biomarkers in nasal lavage were analyzed: nasal eosinophilia (number of eosinophils per high power field), eotaxin-1 and eotaxin-2.
RESULTS: After treatment, significant reductions were observed for all the symptom scores. Forty-two of 78 patients were considered responders. A significant reduction of eosinophils in nasal mucosa and of levels of eotaxin-1 and eotaxin-2 in nasal lavage were observed after treatment in responder patients. Patients with asthma had an increased probability to be responders.
CONCLUSION: NARES patients may benefit from treatment with montelukast. In particular, the presence of concomitant asthma may be predictive of a greater efficacy.
LEVEL OF EVIDENCE: 2. Laryngoscope, 2018.

PMID: 30478909 [PubMed - as supplied by publisher]



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