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Safety of High-Dose Nasal Theophylline Irrigation in the Treatment of Postviral Olfactory Dysfunction: a Dose-Escalation Study - JAMA

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  • Safety of High-Dose Nasal Theophylline Irrigation in the Treatment of Postviral Olfactory Dysfunction: a Dose-Escalation Study - JAMA

    Research Letter

    Published Online: July 7, 2022.

    doi:10.1001/jamaoto.2022.1574

    Jake J. Lee, MD, MSCI

    Olfactory dysfunction (OD) is an increasingly prevalent and debilitating condition associated with acute and chronic SARS-CoV-2 infection.1 Despite the rise in postviral OD (PVOD), to our knowledge, no universally effective treatments exist.2Theophylline is a potential, newer treatment for OD.3 We recently completed a double-blind, placebo-controlled randomized clinical trial (RCT) of patients who received 6 weeks of nasal theophylline irrigation (12 mg twice daily) vs placebo saline irrigation.4 The study found no clinically meaningful differences in olfaction, but the theophylline was likely underdosed.

    We conducted a phase 1, open-label, dose-escalation trial of patients with non-COVID-19–related PVOD of 6 to 36 months’ duration to determine the maximum tolerable dose of theophylline delivered via high-volume, low-pressure nasal saline irrigation. Participants from the previous phase 2 RCT were recruited.4 Institutional review board approval was obtained from Washington University in St Louis. Patients also provided verbal informed consent. ...



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