Azathioprine Reduces The Risk Of Audiometric Relapse In Immune-Mediated Hearing Loss

Introduction: Current schemes for treatment of immune-mediated hearing loss with sporadic short-course, low-dose corticosteroids, are insufficient.Methods: To determine the rote of azathioprine in the control of auditory impairment, a longitudinal, observational, descriptive study was performed with 20 patients treated with azathioprine (1.5-2.5 mg/kg/day into two doses) for 1 year. The loss of 10 dB on two consecutive frequencies or 15 dB on an isolated frequency was considered as relapse.Results: The mean age of the patients was 52.50 years (95% CI: 46.91-58.17), half were women. Bilateral affectation was 65%. 75% had organ specific disease and 25% had systemic autoimmune disease. The difference between baseline PTA (46.49 dB; DS 18.90) and PTA at 12 months (45.47 dB; DS 18.88) did not reach statistical significance (P=.799). There was a moderate positive correlation between female sex and the presence of systemic disease (R=.577). By applying Student's t for paired data, a significant difference (P=.042) was obtained between the PTA in frequencies up to 1000 Hz (PTA 125-1000 Hz). The relative incidence rate of relapse per year was .52 relapses/year (95%CI: .19-1.14]). The median time to audiometric relapse-free was 9.70 months (DS 1.03).Conclusions: Azathioprine maintains the hearing threshold, decreases the risk of relapse, and slows down the rate at which patients relapse, altering the course of immune-mediated inner ear disease. (C) 2018 Sociedad Espanola de Otorrinolaringologia y Cirugia de Cabeza y Cuello. Published by Elsevier Espana, S.L.U. All rights reserved.