Pilocarpine in the management of allergic rhinosinusitis

Pilocarpine in the management of allergic rhinosinusitis | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 8 December 2025 V1 Latest version Share on Pilocarpine in the management of allergic rhinosinusitis Authors : Lydia Theodoropoulou 0009-0000-7344-5818 [email protected] and Niamh A. Cullen Authors Info & Affiliations https://doi.org/10.22541/au.176520983.35360219/v1 164 views 81 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background : This retrospective study addresses the question of inadequate cholinergic output in Allergic Rhinosinusitis (ARS) and the feasibility of treatment with cholinergics. Pilocarpine, a muscarinic-receptor agonist, was administered to patients with refractory obstructive sino-nasal symptoms to improve secretion and clearance. Methods : The 22-item sino-nasal outcome test (SNOT-22) was used to identify patients with recalcitrant obstructive symptoms. Patients were treated with pilocarpine 5 mg tid, bid or qd, and changes of their symptoms scores were compared to those of patients who were not treated with pilocarpine. SNOT-22 was administered on presentation and at follow-up at 3 and 6 months. At 6 months of treatment, pilocarpine was discontinued. At 12-15 months the SNOT-22 was administered again to assess sustainability. Results : Based on SNOT-22 score on presentation, 48 patients were identified as severe obstructive-type ARS cases. Nineteen received pilocarpine; two discontinued treatment due to side effects. Eight subjects required dosing adjustment. SNOT-22 scores were lower in the pilocarpine-treated group at 6 months of treatment and at 6 months after discontinuation (p < 0.05 for both). Longitudinal group-specific SNOT-22 improvement was pronounced in the pilocarpine tid-treated sub-group, both at 6 months of treatment, and at 6-9 months after discontinuation (p < 0.05 and < 0.01 respectively). Significance of SNOT-22 decline was also reached at p < 0.1 for subjects on pilocarpine qd, but was not sustained upon discontinuation. Conclusions : Pilocarpine can be useful in the treatment of refractory sino-nasal blockage. Adverse effects are frequent at 5 mg tid, but lower dosing can be effective. Supplementary Material File (pilocarpine,_rhinosinusitis,_text_dcmbr_2025.doc) Download 91.00 KB File (table 1. demographics.doc) Download 29.50 KB File (table 2. adverse events.doc) Download 31.00 KB File (table 3. outcomes.doc) Download 36.00 KB Information & Authors Information Version history V1 Version 1 08 December 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords allergy treament basic mechanisms ent (rhinitis inflammation mucosal immunity nasal polyps...) pharmacology and pharmacogenomics quality-of-life sinusitis Authors Affiliations Lydia Theodoropoulou 0009-0000-7344-5818 [email protected] Allergy Associates of La Crosse Ltd View all articles by this author Niamh A. Cullen Allergy Associates of La Crosse Ltd View all articles by this author Metrics & Citations Metrics Article Usage 164 views 81 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Lydia Theodoropoulou, Niamh A. Cullen. Pilocarpine in the management of allergic rhinosinusitis. Authorea . 08 December 2025. DOI: https://doi.org/10.22541/au.176520983.35360219/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. 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