Intranasal Lysine‐Aspirin in Aspirin‐Sensitive Nasal Polyposis: A Controlled Trial

Abstract 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.