Quality of Life in NSAIDs-Exacerbated Respiratory Disease on or off Intranasal Lysine Aspirin Therapy

Background: Intranasal administration of lysine aspirin (LAS) is a safe and effective method for aspirin treatment after desensitisation (ATAD). Changes in quality of life (QoL) in patients on intranasal LAS have not been documented and we aimed to investigate QoL in N-ERD patients on or off nasal ATAD. Moreover, an estimate of the cost burden of intranasal LAS is given. Methods: A cross-sectional review was conducted for all challenge-confirmed N-ERD patients who were in follow-up in our rhinology clinic. They were asked to complete a SNOT-22 questionnaire, a visual analogue scale for sense of smell (sVAS). Information on prices of LAS and other consumables used for intranasal ATAD was obtained from our hospital pharmacy to obtain an estimate of the cost burden. Results: Thirty-four patients replied to the email (79.1% response rate). Of these, 21 (61.8%) were on intranasal LAS. A statistically significant lower score in the total SNOT-22 was found amongst patients on intranasal LAS (p = 0.02). The subanalysis of SNOT-22 domains showed that patients on LAS had statistically significant lower scores in the domains “rhinologic symptoms” (p = 0.05), “function” (p = 0.02), and “emotion” (p = 0.01). No significant differences were observed when looking at sVAS. The cost of 1-year treatment of LAS per person was ≈GBP 180.7 with a daily cost of ≈GBP 0.50. Conclusions: This study supports the efficacy of nasal ATAD in the management of N-ERD and suggests that long-term use can lead to QoL improvement with cost benefits.