Auditory changes associated with moderate blood salicylate levels

Area of Science:

• Otolaryngology
• Rheumatology
• Clinical Pharmacology

Background:

• Rheumatoid arthritis (RA) is a chronic inflammatory disease.
• Aspirin (acetylsalicylic acid) is commonly used for pain and inflammation management in RA.
• The ototoxic potential of aspirin at therapeutic doses requires further investigation.

Purpose of the Study:

• To investigate the effect of aspirin on hearing ability in rheumatoid arthritis patients.
• To determine the relationship between blood salicylate levels (BSL) and audiological outcomes.
• To assess the reversibility of any observed hearing changes.

Main Methods:

• Thirty RA patients were randomized into aspirin and placebo groups.
• Aspirin (5 grains) or placebo was administered daily for seven days.
• Blood salicylate levels (BSL) and audiological evaluations (speech reception thresholds, pure-tone thresholds) were conducted on Days 0, 3, and 7.

Main Results:

• Blood salicylate levels in the aspirin group remained below 21 mg/100 ml.
• Significant differences in hearing thresholds were observed between low and high BSL days within both groups.
• Temporary adverse effects on hearing, particularly at high frequencies, were noted with moderate BSLs.

Conclusions:

• Moderate blood salicylate levels, achievable with standard aspirin dosing, can adversely affect hearing ability in RA patients.
• These aspirin-induced hearing impairments appear to be temporary and reversible.
• Further research into aspirin's ototoxicity at therapeutic levels is warranted.