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Azithromycin for the treatment of eosinophilic nasal polyposis: clinical and histologic analysis

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Resumo:Introduction: Macrolides used as immunomodulators are a promising tool for chronic inflammatory airway diseases.Eosinophilic nasal polyposis (ENP) is still considered a disease that is difficult to control with the currently standardized treatments.Objectives: To evaluate prolonged treatment with low-dose azithromycin for ENP based on clinical and histopathologic variables.Methods: The present investigation was a self-paired case study of 33 patients with ENP. A comparison was performed between patients before and after treatment with azithromycin for 8 weeks. The patients were subjected to clinical examinations,staging (three-dimensional imaging by endoscopy), application of the questionnaire, and biopsy of nasal polyps at the beginning and at the end of the treatment. Results: The treatment yielded a clinical improvement regarding the two variables studied: polyposis staging (69.7%) and questionnaire (57.6%). We did not find significant differences in the inflammatory pattern and in the percentage or absolute number of eosinophils per field between samples obtained before and after the treatment (p > 0.05). There was no difference between the answers obtained from groups with and without asthma and/or aspirin intolerance (p>0.3). The patients with advanced initial staging exhibited lower subjective improvement index and staging reduction (p> 0.031 and p > 0.012, respectively). Conclusion: Based on this study, azithromycin may be considered as another therapeutic option for ENP. However, further studies are necessary to define the real mechanism of action involved.
Autores principais:Isamara Simasde Oliveira
Outros Autores:Paulo Fernando Tormin Borges Crosara; Geovanni Dantas Cassali; Diego Carlos Dos Reis; Danilo Santana Rodrigues; Flavio Barbosa Nunes; Roberto Eustáquio Santos Guimarães
Assunto:Macrolides Nasal polyps Azithromycin Eosinophils Macrolídeos Pólipos nasais Azitromicina Eosinófilos
Ano:2023
País:Brasil
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:IBICT
Idioma:português
Origem:Oasisbr
Descrição
Resumo:Introduction: Macrolides used as immunomodulators are a promising tool for chronic inflammatory airway diseases.Eosinophilic nasal polyposis (ENP) is still considered a disease that is difficult to control with the currently standardized treatments.Objectives: To evaluate prolonged treatment with low-dose azithromycin for ENP based on clinical and histopathologic variables.Methods: The present investigation was a self-paired case study of 33 patients with ENP. A comparison was performed between patients before and after treatment with azithromycin for 8 weeks. The patients were subjected to clinical examinations,staging (three-dimensional imaging by endoscopy), application of the questionnaire, and biopsy of nasal polyps at the beginning and at the end of the treatment. Results: The treatment yielded a clinical improvement regarding the two variables studied: polyposis staging (69.7%) and questionnaire (57.6%). We did not find significant differences in the inflammatory pattern and in the percentage or absolute number of eosinophils per field between samples obtained before and after the treatment (p > 0.05). There was no difference between the answers obtained from groups with and without asthma and/or aspirin intolerance (p>0.3). The patients with advanced initial staging exhibited lower subjective improvement index and staging reduction (p> 0.031 and p > 0.012, respectively). Conclusion: Based on this study, azithromycin may be considered as another therapeutic option for ENP. However, further studies are necessary to define the real mechanism of action involved.

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