Abstract
Introduction
Granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis constitude the group of ANCA associated vasculitis (AAV). Ear, nose and throat manifestations are part of the typical clinical presentation of these diseases. Usually, patients are treated with systemic immunomodulatory drugs, mostly based on organ affection. In clinical routine, an insufficient decrease of upper respiratory tract (URT) manifestations during a solely systemic therapeutic concept can repeatedly be observed.
Material and Methods
Between February 2009 and November 2012 20 patients with AAV were diagnosed in or refered to our department for further treatment. Clinical symptoms and manifestations were measured by the use of international accepted activity scores (BVAS, VDI, FFS). The effect of a local therapy with liposomes for a duration of two months on URT 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 URT symptoms. After a two-months period of liposomal local therapy, a significant reduction of URT 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 upper respiratory tract manifestations in patients with ANCA associated vasculitis.
- © 2014 ERS