Predisposing factors of rhinitis medicamentosa: What can influence drug discontinuation?

Eugenio De Corso, Rodolfo Francesco Mastrapasqua, Laura Tricarico, Stefano Settimi, Tiziana Di Cesare, Dario Antonio Mele, Lucrezia Trozzi, Giampiero Salonna, Gaetano Paludetti, Jacopo Galli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: the primary end point of our study was to define risk factors and identify the underlying conditions that may have led to the abuse of vasoconstrictors in rhinitis medicamentosa. Moreover, we analysed factors that may influence the vasocon-strictors discontinuation. Methodology: this was a prospective case-control observational study. Cases and controls were evaluated at the baseline in order define factors that may have influenced onset of rhinitis medicamentosa. They were re-evaluated at 3 months to verify symptoms control and drug discontinuation. Finally, they underwent a phone call questionnaire after 12 months regarding drug disconti-nuation. A potential bias of our study is that evaluating discontinuation we included subjects treated differently according to the main diagnosis. Results: patients with rhinitis medicamentosa were more frequently smokers than controls, they had higher mean HAMA scores and positive psychiatric diseases history. Additionally, we frequently detected a local inflammation at nasal cytology in patients with rhinitis medicamentosa. A significant improvement in all nasal symptoms scores was observed in cases and controls but 29.4% of cases did not discontinue the vasoconstrictors. Two major factors negatively influenced discontinuation: positive nasal cytology and pathological HAMA score. Conclusion: we observed that positive local inflammation, anxiety and smoking habit correlate positively with vasoconstrictors abuse. In addition, we demonstrated that anxiety and local inflammation were the most important factors impairing drug discon-tinuation.

Original languageEnglish
Pages (from-to)233-240
Number of pages8
JournalRhinology
Volume58
Issue number3
DOIs
Publication statusPublished - 2020

Keywords

  • Anxiety
  • Nasal cytology
  • Nasal decongestants
  • Rhinitis
  • Smoking

ASJC Scopus subject areas

  • Otorhinolaryngology

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