[Liposomal local therapy of sinunasal symptoms in ANCA associated vasculitis].
BACKGROUND
GPA, eGPA and MPA constitute the group of AAV. ENT manifestations are part of the typical clinical picture of these diseases. Usually, patients are treated with systemic immunomodulatory drugs, mostly based on organ affection. In clinical routine, an insufficient decrease of sinunasal manifestations during a solely systemic therapeutic concept can repeatedly be -observed.


METHODS
Between February 2009 and November 2012, 20 patients with AAV were diagnosed in or referred to our department for further treatment. Clinical symptoms and manifestations were measured by the use of international accepted activity scores. The effect of a local therapy with liposomes for a period of 2 months on sinunasal symptoms was prospectively evaluated by using visual analogue scales and standardized questionnaires.


RESULTS
Within the described collective 100% of patients did show ENT-symptoms at the time of initial diagnosis. Every patient did receive immunomodulatory therapy, but in 61.1% of cases there was just slight or no improvement on sinunasal symptoms. After a 2-month period of liposomal local therapy, a significant reduction of sinunasal complaints could be observed, both evaluated via visual analogue scales (p<0.001 to p=0.014, depending on the evaluated symptom) and standardized questionnaires (p<0.001).


CONCLUSIONS
The local application of liposomes in addition to a systemic therapy is effective in alleviating sinunasal manifestations in patients with AAV.
Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München.
B
B
Hofauer
Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München.
M
M
Bas
Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München.
U
U
Strassen
Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München.
Y
Y
Matsuba
Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München.
N
N
Mansour
Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München.
A
A
Knopf
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis / Q000188:drug therapy*; D015267:Churg-Strauss Syndrome / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D008081:Liposomes / Q000008:administration & dosage*; D008297:Male; D055953:Microscopic Polyangiitis / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D009668:Nose Diseases / Q000175:diagnosis / Q000188:drug therapy*; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D064232:Visual Analog Scale
D007155:Immunologic Factors; D008081:Liposomes