Verapamil May Be Effective in Severe Chronic Rhinosinusitis

Verapamil, a calcium channel blocker, has shown significant efficacy in alleviating symptoms of patients with chronic rhinosinusitis (CRS) with nasal polyps.

Verapamil, a calcium channel blocker, has shown significant efficacy in alleviating symptoms of patients with chronic rhinosinusitis (CRS) with nasal polyps.

Researchers at Massachusetts Eye and Ear identified that inflammation involved in CRS with nasal polyps is generated by the nasal lining itself, when P-glycoprotein is overexpressed. They conducted a randomized, double-blind, placebo-controlled trial with low-dose verapamil in 18 patients with CRS with nasal polyps. 

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Results showed improved outcomes for the verapamil group compared with the placebo group, although the treatment effect was significantly limited among patients with higher body mass indices. The authors indicated that subsequent trials are being planned to test the efficacy of verapamil at higher doses, which may be needed to produce a therapeutic effect in some patients. 

“Verapamil is a first-generation inhibitor that is well-established in blocking P-glycoprotein,” said Benjamin S. Bleier, MD, and senior author of the study. In some patients with CRS with nasal polyps, we saw dramatic improvement in their symptom scores.”

The current treatment strategy for CRS is long-term steroid use, which entails side effects and doesn’t target the underlying source of the disease. Speaking of verapamil’s potential value in this patient population, Dr. Bleier said, “We observed no significant side effects at the doses we used, and we are very encouraged by the results of this first step toward a more targeted therapy.”

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