Editorial

Intranasal Corticosteroids for the Treatment of Perennial Allergic Rhinitis

Authors: Jeff Stokes, MD, FAAAAI, FACAAI

Abstract

Allergic rhinitis is a one of the most common chronic diseases, affecting 10 to 30% of adults and up to 40% of children.1 Allergic rhinitis is typically categorized based on the timing of the rhinitis symptoms as either seasonal or perennial. One problem with this description is that certain allergens that are seasonal in some areas may be perennial in others. The recent ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines reclassified allergic rhinitis based on a patient’s symptom frequency (intermittent and persistent) and severity (mild and moderate/severe).2

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Newacheck PW, Stoddard JJ. Prevalence and impact of multiple childhood chronic illnesses. J Pediatr 1994;124:40–48.
 
2. Bousquet J, van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001;108(5 Suppl):S147–S334.
 
3. Arbes SJ Jr, Cohn RD, Yin M, et al. House dust mite allergen in US beds: results from the First National Survey of Lead and Allergens in Housing. J Allergy Clin Immunol 2003;111:408–414.
 
4. Arbes SJ Jr, Cohn RD, Yin M, et al. Dog allergen (Can f 1) and cat allergen (Fel d 1) in US homes: results from the National Survey of Lead and Allergens in Housing. J Allergy Clin Immunol 2004;114:111–117.
 
5. Morgan WJ, Crain EF, Gruchalla RS, et al. Results of a home-based environmental intervention among urban children with asthma. N Engl J Med 2004;351:1068–1080.
 
6. Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ 1998;317:1624–1629.
 
7. Yáñez A, Rodrigo GJ. Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis. Ann Allergy Asthma Immunol 2002;89:479–484.
 
8. Nathan RA. Pharmacotherapy for allergic rhinitis: a critical review of leukotriene receptor antagonists compared with other treatments. Ann Allergy Asthma Immunol 2003;90:182–191.
 
9. Allen DB. Systemic effects of intranasal steroids: an endocrinologist’s perspective. J Allergy Clin Immunol 2000;106:S179–190.
 
10. Corren J. Intranasal corticosteroids for allergic rhinitis: how do different agents compare? J Allergy Clin Immunol 1999;104(4 Pt 1):S144–149.
 
11. Holm AF, Fokkens WJ, Godthelp T, et al. A 1-year placebo-controlled study of intranasal fluticasone propionate aqueous nasal spray in patients with perennial allergic rhinitis: a safety and biopsy study. Clin Otolaryngol Allied Sci 1998;23:69–73.
 
12. Skoner DP, Rachelefsky GS, Meltzer EO, et al. Detection of growth suppression in children during treatment with intranasal beclomethasone dipropionate. Pediatrics 2000;105:E23.
 
13. Schenkel EJ, Skoner DP, Bronsky EA, 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:E22.
 
14. Ober S, Gentile D, Kairis E, et al. Growth velocity and HPA axis function during 1-year treatment with triamcinolone acetonide aqueous (TAA) nasal spray in children with allergic rhinitis. J Allergy Clin Immunol 2005;115:S267.
 
15. Allen DB, Meltzer EO, Lemanske RF Jr, et al. No growth suppression in children treated with the maximum recommended dose of fluticasone propionate aqueous nasal spray for one year. Allergy Asthma Proc 2002;23:407–413.
 
16. Moller C, Ahlstrom H, Henricson KA, et al. Safety of nasal budesonide in the long-term treatment of children with perennial rhinitis. Clin Exp Allergy 2003;33:816–822.
 
17. Joint Task Force on Practice Parameters. Allergen immunotherapy: a practice parameter. American Academy of Allergy, Asthma and Immunology. American College of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol 2003;90:1–40.
 
18. Chervinsky P, Casale T, Townley R, et al. Omalizumab, an anti-IgE antibody, in the treatment of adults and adolescents with perennial allergic rhinitis. Ann Allergy Asthma Immunol 2003;91:160–167.