A clinical trial studying using Verapamil (a drug currently in use for cardiovascular disease and cluster headache) in relieving chronic rhinosinusitis (CRS) with nasal polyps revealed significant improvement in the symptoms of this subset of patients. It's the primary study of its kind to explore treatment for CRS by inhibiting P-glycoprotein, a protein pump inside the nasal lining that Mass. Eye and Ear research workers formerly identified as a mechanism for these acute cases of CRS marked by the existence of nasal polyps. The clinical trial results, published on the internet in the Journal of Allergy and Clinical Immunology: In Practice, suggest that Verapamil represents a promising novel therapy for treating CRS.
"Recently, we became aware that a number of the inflammation in CRS with nasal polyps is generated by the nasal liner itself, when a certain protein pump (P-glycoprotein) is overexpressed and leads to the hyper secretion of inflammatory cytokines," said senior author Benjamin S. Bleier, M.D., a sinus surgeon at Mass. Eye and Ear and an assistant professor of otolaryngology at Harvard Medical School. "Verapamil is a first-generation inhibitor that is well-established in blocking P-glycoprotein. In a few patients with CRS with nasal polyps, we saw dramatic advancement within their symptom scores."
Some of the more common chronic illnesses in the USA, CRS continues to be proven to cause major quality of life detriments to affected patients, who regularly cannot sleep or breathe readily due to obstructed nasal and sinus passages. The existence of nasal polyps represents a specially intense presentation of the disease. Present therapy strategies (most commonly long term steroid use) are plagued by troublesome negative effects and neglect to target an underlying source of the disease.
Moved by their previous finding of the existence of P-glycoprotein overexpression in the nasal lining of patients with CRS with nasal polyps, the study authors conducted a randomized, double-blind, placebo-controlled clinical trial studying using low-dose Verapamil in 18 patients with CRS with nasal polyps. An evaluation of the patients demonstrated improved outcomes for those in the Verapamil group in regard to those in the placebo group. But, the researchers also found the treatment effect was restricted among patients with higher body mass indices. Future studies are being planned to determine if a higher dose of Verapamil may be required to be curative for some patients.
"Chronic rhinosinusitis with nasal polyps is among our most challenging diagnoses to treat, because these patients essentially have continual, lifelong inflammation that needs continual, lifelong treatment," said Dr. Bleier. "We detected no major unwanted side effects in the doses we used, and we're really encouraged by the outcomes of this first step toward a more targeted therapy for our patients." More details on the article can be found at chronic pain forums