Effects of suplatast tosilate on nasal obstruction related to perennial allergic rhinitis in non-responders to leukotriene receptor antagonists

Abstract

As leukotriene receptor antagonists (LTRAs) are effective for nasal obstruction related to allergic rhinitis,they are routinely used, but ineffective in some cases. In this study, we administered a Th2 cytokine inhibitor,suplatast tosilate (ST), to perennial allergic rhinitis patients non-responsive to LTRAs, and examined its effects on nasal obstruction by recording the nasal cavity on video. An LTRA or ST was administered to 397 patients with allergic rhinitis complaining of nasal obstruction as a primary symptom between May 2013 and May 2014. Of these, 45 were diagnosed with perennial allergic rhinitis and regarded as non-responders to LTRAs；ST was administered. Of the 30 patients who could be analyzed, the efficacy of ST was confirmed in 17 (56.7％).In13 of these, its effects were achieved within 1 month. With respect to the severity of swelling of the inferior concha mucosa, the response rates in patients with marked (+++), moderate (++), and slight (+) swelling were 85.7％ (6/7), 56.3％ (9/16),and 28.6％ (2/7), respectively；ST was more effective in severe-status patients. Even responders temporarily showed deterioration due to acute upper airway inflammation. ST may be useful for the treatment of allergic rhinitis-related nasal obstruction in non-responders to LTRAs.