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Long-term role of zileuton in the treatment of chronic rhinosinusitis in aspirin exacerbated respiratory disease
Journal article   Peer reviewed

Long-term role of zileuton in the treatment of chronic rhinosinusitis in aspirin exacerbated respiratory disease

Chadi A. Makary, Thomas Holmes, Aykut Unsal, Ananya Munjal, Lindsey Ryan, Camilo Reyes and Stilianos E. Kountakis
American journal of otolaryngology, v 43(1), 103227
Jan 2022
DOI: https://doi.org/10.1016/j.amjoto.2021.103227
PMID: 34563805
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

AERD Chronic rhinosinusitis Nasal polyposis Outcome Zileuton
Chronic rhinosinusitis (CRS) in the setting of Aspirin Exacerbated Respiratory Disease (AERD) have high rate of treatment failure and disease recurrence. Evaluate the long-term effect of zileuton on sinonasal outcomes in patients with AERD. AERD patients were reviewed and divided into two cohorts, depending if they were treated with zileuton during their clinical course. Demographic data, 22-item sinonasal outcome test (SNOT-22), Lund-Kennedy (LK) endoscopy score, duration of treatment, and number of sinus surgeries performed were collected. 40 AERD patients were included, with follow-up duration up to 10 years (avg of 5.2 years). All patients were treated with topical saline and budesonide irrigations, intranasal steroid spray, and montelukast. 19 patients had uncontrolled sinus disease requiring multiple steroid tapers and were switched from montelukast to zileuton (cohort 1, 47.5%) at some point in their treatment. 21 patients (cohort 2, 52.5%) never needed zileuton. The average duration of treatment with zileuton was 6 years. Patients who required zileuton had a worse SNOT-22 (32.1 vs 19, p = 0.117), worse LK score (8.1 vs 7.5, p = 0.504), and higher average number of surgeries (1.9 vs 1.6, p = 0.343). The outcomes in the zileuton cohort trended toward improvement, however these did not reach statistical significance with an improved SNOT-22 from 32.1 to 27.4 (p = 0.617) and LK score from 7.9 to 6.2 (p = 0.092); The addition of zileuton significantly lowered the number of surgeries needed to an average of 0.5 (p < 0.0001). Zileuton may help decrease the number of sinus surgeries needed in AERD.

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9 citations in Web of Science
11 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Otorhinolaryngology
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