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3 results

  • Epistaxis and atorvastatin: is there an association and are clinicians aware? A retrospective audit of 100 patients

  • E Heward, A S Lau
  • Journal:
    The Journal of Laryngology & Otology / Volume 134 / Issue 2 / February 2020
    Published online by Cambridge University Press:
    22 January 2020, pp. 138-140
    Print publication:
    February 2020
  • Objective

    Epistaxis is a common ENT presentation. The British National Formulary lists epistaxis as a common side effect of atorvastatin. This study aimed to better understand the relationship between epistaxis and atorvastatin use, and determine whether ENT doctors are aware of its side effect profile.

    Methods

    A retrospective analysis over 10 months identified 100 individuals who presented to hospital with epistaxis. A questionnaire of 24 ENT registrars was undertaken.

    Results

    Of the 100 patients admitted with epistaxis, 27 were receiving atorvastatin and 21 simvastatin. None of the 24 ENT registrars were aware that epistaxis was a listed common side effect of atorvastatin.

    Conclusion

    There was no apparent difference in the proportion of patients admitted with epistaxis taking atorvastatin versus simvastatin. Epistaxis is an unknown side effect of atorvastatin; doctors have an obligation to be aware of the pharmaceutical literature and to consider alternatives, particularly in re-admissions cases.

  • 38 - Intravenous immunoglobulin to treat multiple sclerosis

  • from Section III - Clinical trials of multiple sclerosis therapies
  • Edited by Jeffrey A. Cohen, Richard A. Rudick
  • Book:
    Multiple Sclerosis Therapeutics
    Published online:
    05 December 2011
    Print publication:
    20 October 2011, pp 444-453

  • Summary

    This chapter reviews the mechanism of action of cladribine, summarizes data from clinical trials in patients with multiple sclerosis (MS), and provides guidance on the management of these patients in clinical practice. The study of parenteral cladribine showed encouraging results, which lead to the development of an oral tablet formulation. Cladribine is rapidly absorbed with Cmax within 30- 50 minutes after oral administration. CLARITY, a 96-week, placebo-controlled Phase 3 study of cladribine tablets as an annual short-course oral monotherapy in RRMS, was recently completed and the principal results published. Benefit of doses of cladribine over placebo was demonstrated for a variety of clinical and imaging end-points. The most common adverse events in the patients were lymphopenia, headache, nasopharyngitis, and upper respiratory tract infections (URTI). The outcomes observed during the CLARITY study were associated with a reduced consumption of health care resources and a decreased need for medical and societal support.

  • Treatment of chronic nasopharyngitis with monopolar suction diathermy

  • J Bartley, C Barber
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 4 / April 2010
    Published online by Cambridge University Press:
    14 October 2009, pp. 426-427
    Print publication:
    April 2010
  • Introduction:

    Chronic nasopharyngeal infection is rare. To our knowledge, no effective treatment for this condition has previously been described. This report documents our experience of using suction ablation diathermy in this clinical setting.

    Method:

    We performed a prospective review of four patients aged 23–65 years (two men and two women) who presented with chronic nasopharyngitis. Initial medical management consisted of regular saline irrigation plus a 14-day course of doxycycline 100 mg daily, combined with rifampicin 200 mg twice daily. When this proved unsuccessful, patients subsequently received a four-week course of omeprazole 40 mg daily, also unsuccessfully. Given these treatments' lack of success, surgery was undertaken.

    Results:

    Following suction diathermy ablation, nasopharyngeal crusting took four to six weeks to settle. After this, all patients ceased to cough up crusts or infected mucus.

    Conclusions:

    Chronic nasopharyngitis is uncommon. If medical management fails, suction ablation diathermy is a useful surgical treatment option.