248 HLA-B58 Does not Increase Allopurinol Hypersensitivity among Patients with Hematologic Malignancy
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چکیده
247 Health-Related Quality of Life and Prognostic Value of Acoustic Rhinometry in Patients With Perennial Allergic Rhinitis Treated with Fix Combination of Montelukast Plus Desloratadine Cemal Cingi, MD, ORL & HNS, Fatih Oghan, MD, ORL & HNS, DPU, Gorkem Eskiizmir, MD, ORL & HNS, Aytekin Yaz, MD, ORL & HNS, Ahmet Ural, ORL & HNS, and Nagehan Erdogmus, ORL & HNS. Osmangazi University, Faculty of Medicine, Eskisehir, Turkey; Medical School, Kutahya, Turkey; Celal Bayar University, Medical School, Manisa, Turkey; Tepecik Training and Research Hospital, Izmir, Turkey; Karadeniz Technical University, Medical School, Trabzon, Turkey. Objective: To determine prognostic value of acoustic rhinometry in patients with perennial allergic rhinitis (PAR) treated with montelukast in fix combination with desloratidine and to assess effectiveness of this medication on health-related quality of life (HRQL). Study design: A randomized, double-blind, prospective and multicentric clinical study. Setting: Tertiary university hospitals. Methods: Patients 20 years of age and older with PAR were assessed over 3 months of treatment with fix combination of montelukast 10 mg plus desloratidine 5 mg once daily (n 1⁄4 40). Comparative acoustic rhinometric evaluation was used to compare nasal changes in before and after treatments. For evaluation of HRQL between before and after treatments at the first and third months, the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used. Results: Nasal symptoms and findings including itching, sneezing, discharge, congestion and edema and color change of turbinates have been decreased after treatment. In acoustic rhinometry, minimum cross-sectional area (MCA) measurements and volume results were statistically higher than in before treatment (P, 0.001). Correlation was found that between the volume results and nasal discharged and/or congestion in right nasal passages. In left nasal passages, statistical relation was described between the MCA measurements and itching and/or change of turbinate color (P , 0.05). There was a larger decrease in the overall RQLQ score for the group using montelukast plus desloratidine compared with the pre-treatment scores (P , 0.001). The difference between scores at baseline versus the end of the first and third months for all domains was statically significant (P , 0.001). The treatment difference in change from first month to the end of the third month was statically significant, in favor of the third month, for eye, nose, and nonnose/eye symptoms, sleep, practical problems, emotions and activities that have been limited by nose or eye symptoms, and for overall score. Conclusions: Significant reductions in signs and symptoms of PAR with montelukast plus desloratadine treatment were accompanied by improved disease-specific QOL measures. Montelukast in combination with desloratidine provides improvements in acoustic rhinometric values including volume and MCA in patients with PAR. Acoustic rhinometry should be use in diagnostic and prognostic process in patients with PAR.
منابع مشابه
Allopurinol Hypersensitivity in Hematologic Malignancy
Allopurinol, a widely used urate-lowering agent, is a leading cause of severe cutaneous adverse reactions (SCARs), especially in patients with HLA-B*58:01. Despite its routine use for the prevention of tumor lysisrelated hyperuricemia prior to chemotherapy, the risk of allopurinol-induced hypersensitivity has not been investigated in patients with hematologic malignancies. This retrospective co...
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BACKGROUND Although allopurinol is a very effective urate-lowering drug for complicated hyperuricemia, in some patients, it can induce severe cutaneous adverse reactions (SCARs). Recent investigations suggest that HLA-B*5801 is a very strong marker for allopurinol-induced SCARs, especially in the population with a high frequency of HLA-B*5801. Korea is one of the countries with a high frequency...
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