Lack of long‐term add‐on effect by montelukast in postoperative chronic rhinosinusitis patients with nasal polyps

Gerven, Laura Van; Langdon, Cristóbal; Forner-Cordero, Arturo; Cardelús, Sara; Mullol, Joaquim; Alobid, Isam

doi:10.1002/lary.26989

Cited by 18 publications

(14 citation statements)

References 21 publications

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“…One year after surgery, they found comparable results in polyp recurrence rate in both groups. In contrast, Van Gerven et al [32] compared postoperative monotherapy applying intranasal corticosteroids (INCS) with INCS and montelukast p.o. in a prospective, randomized setting ( N = 72).…”

Section: Discussionmentioning

confidence: 99%

“…in a prospective, randomized setting ( N = 72). In their study, no significant difference in subjective and objective scores of the 2 treatment arms was seen 1 year after surgery, suggesting no further benefit of MT for the treatment of CRSwNP [32]. Here certainly a larger scale study with a significant number of patients is needed to effectively describe the impact of MT in CRSwNP.…”

Section: Discussionmentioning

confidence: 99%

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AERD Associated Nasal Polyposis: Efficacy of Postoperative Antileukotriene Therapy in Comparison with Aspirin Desensitization. A Retrospective Study

Nicoló

Habermann

Havel

2020

Int Arch Allergy Immunol

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Introduction: AERD (aspirin-exacerbated respiratory disease) is a severe form of an inflammatory disease of the upper airway system. Therapy remains challenging due to a complex underlying pathophysiology. Objective: To evaluate the efficacy of postoperative antileukotriene therapy concerning recurrence of nasal polyposis in patients with AERD and to compare it with AD (aspirin desensitization) over time. Methods: In this retrospective study we analyzed AERD patients (N = 61) after functional endoscopic sinus surgery (FESS). Patients were treated at our institution postoperatively with topical mometasone (control group, N = 22), leukotriene-receptor-antagonists (montelukast [MT], N = 18) or underwent an aspirin desensitization (N = 21). Subjective parameters as assessed by SNOT (sinonasal outcome test) questionnaire and endoscopic endonasal examination (polyposis grading) were evaluated throughout a follow-up period of 6-9 and >12 (long-term) months after surgery. Results: Endoscopic endonasal examinations 6-9 months after sinus surgery showed a good disease control in all 3 groups with significant reduction in polyp grading in the AD group. After a follow-up period of more than 12 months, MT and AD patients had significantly less polyp recurrences as compared to the topical treatment group. Subjective sinonasal symptoms revealed that hyposmia and nasal obstruction were prominent factors in all 3 groups throughout the follow-up period. MT group showed significant improvement in sinonasal symptoms over time. Conclusion: Postoperative treatment with leukotriene-receptor-antagonists and aspirin desensitization both significantly reduce nasal polyp recurrence. MT has a positive effect on subjective sinonasal outcomes and patients' quality of life over time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

AERD Associated Nasal Polyposis: Efficacy of Postoperative Antileukotriene Therapy in Comparison with Aspirin Desensitization. A Retrospective Study

Nicoló

Habermann

Havel

2020

Int Arch Allergy Immunol

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“…Montelukast had a strong inhibitory effect on Fetal Bovine Serum (FBS) ‐induced GM‐CSF, IL‐6, and IL‐8 secretion but not on ICAM‐1. These anti‐inflammatory effects on epithelial cell cytokine secretion and on eosinophil survival suggest that montelukast may contribute to the reduction of eosinophilic inflammation in upper‐airway inflammatory diseases such as rhinitis and nasal polyposis …”

Section: Discussionmentioning

confidence: 99%

“…These anti-inflammatory effects on epithelial cell cytokine secretion and on eosinophil survival suggest that montelukast may contribute to the reduction of eosinophilic inflammation in upper-airway inflammatory diseases such as rhinitis and nasal polyposis. 30 In contrast to the extensive amount of information found in the literature on AR, there is limited data on the treatment of NAR, 8 for which the intense symptoms can negatively affect the patient's quality of life. Our preliminary results suggest for the first time that some NARES patients may significantly benefit from treatment with montelukast 10 mg once a day.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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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, 129:551–557, 2019

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“…The endoscopic modified Lothrop procedure, together with continual medical treatment for the secondary prevention of NP recurrence, is an optimal treatment for patients with CRSwNP 8586. Leukotriene modifiers did not show additional benefit in the prevention of disease progression in CRSwNP 87. Omalizumab has been shown to be effective in both CRSwNP and CRSsNP patients.…”

Section: Treatmentmentioning

confidence: 96%

Update on the Management of Nonsteroidal Anti-Inflammatory Drug Hypersensitivity

Yeung

Park

2020

Yonsei Med J

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The clinical phenotypes of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity are heterogeneous with various presentations including time of symptom onset, organ involvements, and underlying pathophysiology. Having a correct diagnosis can be challenging. Understanding their respective mechanisms as well as developing a comprehensive classification and diagnostic algorithm are pivotal for appropriate management strategy. Treatment modalities are based on the subtypes and severity of hypersensitivity reactions. Insights into the phenotypes and endotypes of hypersensitivity reactions enable personalized management in patients with suboptimal control of disease. This review updated the recent evidence of pathophysiology, classification, diagnostic algorithm, and management of NSAID hypersensitivity reactions.

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Lack of long‐term add‐on effect by montelukast in postoperative chronic rhinosinusitis patients with nasal polyps

Abstract: 1b Laryngoscope, 1743-1751, 2018.

Cited by 18 publications

References 21 publications

AERD Associated Nasal Polyposis: Efficacy of Postoperative Antileukotriene Therapy in Comparison with Aspirin Desensitization. A Retrospective Study

AERD Associated Nasal Polyposis: Efficacy of Postoperative Antileukotriene Therapy in Comparison with Aspirin Desensitization. A Retrospective Study

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

Update on the Management of Nonsteroidal Anti-Inflammatory Drug Hypersensitivity

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