The Effect of Zileuton on Anosmia in Aspirin-Sensitive Asthmatics

Anosmia is a common accompanying symptom in aspirin-sensitive asthmatics with the “ASA Hypersensitivity Triad” of eosinophilic rhinitis, nasal polyposis, and hyperplastic sinusitis. During a 12-month investigational drug trial with Zileuton, an inhibitor of 5-lipoxygenase, 3 of 12 patients with mild to moderate asthma were identified to be aspirin-sensitive and anosmic. We describe these three cases and their olfactory response using a three item forced choice odor identification test. All three patients noted persistent improvement in their sense of smell after institution of Zileuton and during the first 12 months of drug administration. Inhibition of the production of leukotrienes by 5-lipoxygenase inhibition may cause clinically significant reduction in upper airway inflammation in aspirin-sensitive patients.