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

• Autor(a) principal: Isamara Simasde Oliveira
• Data de Publicação: 2016
• Outros Autores: Paulo Fernando Tormin Borges Crosara, Geovanni Dantas Cassali, Diego Carlos Dos Reis, Danilo Santana Rodrigues, Flavio Barbosa Nunes, Roberto Eustáquio Santos Guimarães
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.2500/ar.2016.7.0160; http://hdl.handle.net/1843/56036
• topic: Macrolides; Nasal polyps; Azithromycin; Eosinophils; Macrolídeos; Pólipos nasais; Azitromicina; Eosinófilos

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.