“Immunoterapia specifica nasale e terapia combinata antistaminica corticosteroidea topica nel trattamento della poliposi nasale allergica”

Objective Nasal polyposis (NP) is a frequent complication of allergic rhinitis still waiting for effective treatment. Aim of this study was to evaluate in NP the effects of two different therapeutic regimens,already proven efficacious in the treatment of allergic rhinitis. Patients and Methods Fortyfour NP house dust mite sensitive pts aged 34-62 years (25 M,19 F) scored 12-14 according to the CT Lund and Mackay scale,were randomized in two matches group of 22 pts,one undergoing a 1 year Local Nasal Immunotherapy (LNIT) treatment, the other treated with Loratidine (10 mg/day) plus Mometasone furoate 100 mcg per nostril/day) –LM- for two separate 5 months cycles with a 2 months wash-out period in between cycles. Anamnestic data and allergy tests were performed at the enrollment of pts while outcome of treatment was evaluated on the basis of the symptom diary cards, fiberoptic endoscopy (FE),CT scan of nose and sinuses, rhinomanometry (AAR), specific nasal provocation test (sNPT) recorded at the beginning and at the end of one year treatment. Results A significative improvement of NP was observed in 19 (86.3%) pts treated with LNIT and in 20(90.9%) pts treated with LM. In both groups the size of polyps at FE, the symptoms score and the CT score improved while the nasal flow at AAR and the threshold of reactivity at NPTs increased after treatment. Side effects were not relevant in both groups. No significant difference was observed between LNIT and LM for all parameters considered and for rescue medications used. Conclusions: One year course of LNIT and LM association represent effective and safe treatments of NP in pts with house dust mite sensitization