Unified disease, unified management: Treating allergic rhinitis and asthma with nasally inhaled corticosteroid

• Published in: Respiratory medicine Vol. 104; no. 10; pp. 1577 - 1580
• Main Authors: Ribeiro de Andrade, Cláudia, Chatkin, José Miguel, Fiterman, Jussara, Scaglia, Noris, Camargos, Paulo Augusto
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.10.2010; Elsevier; Elsevier Limited
• Subjects: Administration, Inhalation; Administration, Intranasal; Adolescent; Adrenal Cortex Hormones - administration & dosage; Allergic rhinitis; Androstadienes - administration & dosage; Asthma; Asthma - drug therapy; Asthma - physiopathology; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; Child; Chronic obstructive pulmonary disease, asthma; Disease; Female; Fluticasone; Humans; Inhaled corticosteroid; Male; Medical sciences; Nitric oxide; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pharmacology. Drug treatments; Pneumology; Pulmonary/Respiratory; Rhinitis, Allergic, Perennial - drug therapy; Rhinitis, Allergic, Perennial - physiopathology; Treatment; Treatment Outcome; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Young Adult; Brazil; Treatment; Allergic rhinitis; Inhaled corticosteroid; Asthma; Immunopathology; Lung disease; Allergy; Corticosteroid; Nose disease; Disease; Rhinitis; Respiratory disease; Inhalation; ENT disease; Bronchus disease; Obstructive pulmonary disease; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2010.06.021

Summary Persistent allergic rhinitis (AR) and asthma constitute a common comorbidity. Combined treatment is recommended by prescribing intranasal plus oral inhaled corticosteroids. This study was carried out to assess the efficacy of an alternative regimen to treat this condition. All recruited patients suffered from persistent AR and asthma. Diagnosis and classification of AR and asthma were based on international guidelines. The experimental group received fluticasone propionate (FP), 500 μg/day during six weeks, inhaled exclusively through the nose using a valved large volume spacer attached to a facemask. The comparison group also received the same dose of orally inhaled FP, during the same time period, plus intranasal aqueous fluticasone, 200 μg/day. There were no statistical differences between both groups regarding AR and asthma severity, clinical scores, acoustic rhinometry, lung function, and FeNO upon admission and during the follow up period. Intragroup analysis demonstrated a significant improvement for allergic rhinitis and asthma scores as well as for FeNO from admission to the sixth week ( p < 0.01) in both groups. Results suggest that exclusive nasally inhaled fluticasone propionate should be considered as an alternative step in the management of patients suffering from AR and asthma comorbidity.