Intranasal glucocorticosteroids: facts and myths
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Abstract
For more than 40 years intranasal glucocorticosteroids are used with good therapeutic effect for the treatment of inflammatory diseases of then nose and sinuses, in particular allergic rhinitis and nasal polyps. Many of these pathologies are chronic in their nature, all of them have the negative impact on patients’ quality of life. Hence the important is that the treatment should be not only the highly effective, but also safe and easy to apply. Administered intranasally, right there, where the pathology is localized, the modern molecules of intranasal steroids, fulfill the requirements for safety, efficacy and appropriate application. Intranasal application is responsible for the strong anti-inflammatory local action, while eliminating systemic side effects of steroids. Appearing small local adverse reactions, in may cases could be easily avoided by correct application of the drug. Despite proven in many clinical studies, high efficiency of intranasal glucocorticosteroids, recommendations contained in international and national documents concerning the treatment of inflammation of the nose and paranasal sinuses, a huge number of publications and rich experiences from the daily practice, still remain unfounded fears, both among physicians and patients or caregivers of children, which significantly limit the use of these drugs, both in the treatment of allergic rhinitis, chronic sinusitis, or other pathologies where the key symptom is severe nasal congestion, resulting from the presence of inflammation.
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
2. Samoliński B., Arcimowicz M. (red.): Polskie Standardy leczenia Nieżytów Nosa (PoSLeNN). Stanowisko Panelu Ekspertów PTA. Alergologia Polska 2013, S1: 1-167.
3. Brozek J.L., Bousquet J., Baena-Cagnani C.E. et al.: Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. Allergy Clin. Immunol. 2010, 126(3): 466-476.
4. Seidman M.D., Gurgel R.K., Lin S.Y.:Clinical practice guideline: Allergic rhinitis. Otolaryngol. Head Neck Surg. 2015, 152(1 supl.): S1-43.
5. Roberts P., Xatzipsalti M., Bornego L.M. et al.: Paediatric rhinitis: Position paper of the European Academy of Allergology and Clinical Immunology. Allergy 2013, 68: 1102-1116.
6. Meltzer E.O.: The Role of Nasal Corticosteroids in the Treatment of Rhinitis. Immunol. Allergy Clin. Immunol. N. Am. 2011, 31: 545-560.
7. Derendorf H., Meltzer E.O.: Molecular and clinical pharmacology of intranasal corticosteroids and therapeutic implications. Allergy 2008, 63: 1292-1300.
8. Schenkel E.J., Skoner D.P., Bronsky E.A. et al.: Absence of growth retardation in children with perennial allergic rhinitis after one year of treatment with mometasone furoate aqueous nasal spray. Pediatrics 2000, 105(2): e22.
9. Meltzer E.O.: Allergic rhinitis: Managing the pediatric spectrum. Allergy Asthma Proc. 2006, 27: 2-8.
10. Ratner P.H., Meltzer E.O., Teper A.: Mometasone furoate nasal spray is safe and effective for 1-year treatment of children with perennial allergic rhinitis. Int. J. Pediatr. Otorhinolaryngol. 2009, 73: 651-657.
11. Tripathy I., Levy A., Ratner P. et al.: HPA axis safety of fluticasone furoate nasal spray once daily in children with perennial allergic rhinitis. Pediatr. Allergy Immunol. 2009, 20(3): 287-294.
12. Baena-Cagnani C.E., Patel P.: Efficacy and long-term safety of mometasone furoate nasal spray in children with perennial allergic rhinitis. Curr. Med. Res. Opin. 2010, 26: 2047-2055.
13. Emin O., Fatih M., Emre D., Nedim S.: Lack of bone metabolism side effects after 3 years of nasal topical steroids in children with allergic rhinitis. J. Bone Miner. Metab. 2011, 29: 582-587.
14. Scadding G.K.: Optimal management of allergic rhinitis. Arch. Dis. Child. 2015, 100(6): 576-582
15. Samoliński B., Nowicka A., Wojas O. et al.: Intranasal glucocorticosteroids – not only in allergic rhinitis. In the 40th anniversary of intranasal glucocorticosteroids’ introduction. Otolaryngol. Pol. 2014, 68(2): 51-64.
16. Oakley G.M., Harvey R.J.: Topical Steroids. Adv. Otorhinolaryngol. 2016, 79: 121-130.
17. Bousquet J., van Cauwenberge P., Khaltaev N. et al.: Allergic Rhinitis and its Impact on Astma. ARIA workshop report. J. Allergy Clin. Immunol. 2001, 108(supl. 5): 147-336.
18. Okano M.: Mechanisms and clinical implications of glucocorticoids in the treatment of allergic rhinitis. Clin. Exp. Immunol. 2009, 158: 164-173.
19. Makihara S., Okano M., Fujiwara T. et al.: Early internentional treatment with intranasal mometasone furoate in Japanese cedar/cypress pollinosis: a randomized placebo-controlled trial. Allergol. Int. 2012, 61: 295-304.
20. Dykewicz M.S., Kaiser H.B., Nathan R.A. et al.: Fluticasone propionate aqueous nasal spray improves nasal symptoms of seasonal allergic rhinitis when used as needed (prn). Ann. Allergy Asthma Immunol. 2003, 91: 44-48.
21. Acar M., Cingi C., Sakallioglu O. et al.: The effects of mometasone furoate and desloratadine in obstructive sleep apnea syndrome patients with allergic rhinitis. Am. J. Rhinol. Allergy 2013, 27(4): e113-116.
22. Nacleiro R.: Intranasal corticosteroids reduced ocular symptoms associated with allergic rhinitis. Otolaryngol. Head Neck Surg. 2008, 138: 129-139.
23. Bielory L., Chun Y., Bielory B.P. et al.: Impact of mometasone furoate nasal spray on individual ocular symptoms of allergic rhinitis: a meta-analysis. Allergy 2011, 66: 686-693.
24. Lohia S., Schlosser R.J., Soler Z.M.: Impact of intranasal corticosteroids on asthma outcomes in allergic rhinitis: a meta-analysis. Allergy 2013, 68(5): 569-579.
25. Craig T.J., Sherkat A., Safaee S.: Congestion and sleep impairment in allergic rhinitis. Curr. Allergy Asthma Rep. 2010, 10(2): 113-121.
26. Schafer T., Schnoor M., Wagenmann M. et al.: Therapeutic Index (TIX) for intranasal corticosteroids in the treatment of allergic rhinitis. Rhinology 2011, 49(3): 272-280.
27. Sharpe S.A., Sandweiss V., Tuazon J. et al.: Comparison of the flow properties of aqueous suspension corticosteroid nasal sprays under differing sampling conditions. Drug Dev. Ind. Pharm. 2003, 29(9): 1005-1012.
28. Fokkens W.J., Lund V.J., Mullol J. et al.: European position paper on rhinosinusitis and nasal polyps (EPOS) 2012. Rhinology 2012, supl. 23: 1-298.
29. Greiner A.N., Hellings P.W., Rotiroti G., Scadding G.K.: Allergic rhinitis. Lancet 2011, 378(9809): 2112-2122.
30. Ahmadi N., Snidvongs K., Kalish L. et al.: Intranasal corticosteroids do not affect intraocular pressure or lens opacity: a systemic review of controlled trials. Rhinology 2015, 53(4): 290-302.
31. Şimşek A., Bayraktar C., Doğan S. et al.: The effect of long-term use of intranasal steroids on intraocular pressure. Clin. Ophthalmol. 2016, 10: 1079-1082.
32. Minshall E., Ghaffar O., Cameron L. et al.: Assessment by Nasal Biopsy of Long-Term Use of Mometasone Furoate Aqueous Nasal Spray (Nasonex) in the Treatment of Perennial Rhinitis. Otolaryngol. Head Neck Surg. 1998, 118: 648-654.
33. Bhargava R., Chakravarti A.: Role of mometasone furoate aqueous nasal spray for management of adenoidal hypertrophy in children. J. Laryngol. Otol. 2014, 128(12): 1060-1066.
34. Ridolo E., Caminati M., Martignago I. et. al.: Allergic rhinitis: pharmacotherapy in pregnancy and old age. Expert Rev. Clin. Pharmacol. 2016, 9(8): 1081-1089.
35. Mygind N.: Rola glikokortykosteroidów podawanych donosowo w leczeniu nieżytów nosa W: Samoliński B., Janczewski G. (red.): Nieżyty nosa. Wydawnictwo Naukowe Scholar, Warszawa 2000: 95-110.
36. Samoliński B., Krzeski A., Chęciński P., Pierchała K.: Wskazania i przeciwwskazania do miejscowej kortykosteroidoterapii. Otolaryngol. Pol. 1994, supl. 17: 33-40.
37. Tran N.P., Vickery J., Blaiss M.S.: Management of Rhinitis: Allergic and Non-Allergic. Allergy Asthma Immunol. Res. 2011, 3(3): 148-156