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SELECTED ARTICLES FROM THE RECENT LITERATURE 2008
10/23/2008
Dose response to intranasal steroids
Summary
The investigators of this project enrolled 69 patients with persistent allergic rhinitis and treated them with intranasal triamcinolone acetonide for 28 days. Patients were divided into those with mild intermittent symptoms, and those with more severe symptoms. Those with mild intermittent symptoms were instructed to use the medication, once daily, only after symptoms occurred. If symptoms persisted more than a day and/or interrupted daily activities or sleep, patients were instructed to continue a morning dose until they were symptom free for 24 hours. At that point, they were told to stop the medication.
There was improvement in symptom scores and peak expiratory flow index in all patients. After 28 days of therapy, the number of puffs utilized was positively correlated with improvement in total symptom score as well as peak expiratory flow. With a dose of 1400 mcg (44 puffs), there was 60% improvement in total symptom scores and 10% improvement in peak expiratory flow.
The authors concluded that self adjustment of dosage was efficacious, and that there was a clearcut dose response effect.
Reference
Kirtsreesakul V, et al. Dose-related effect of intranasal corticosteroids on treatment outcome of persistent allergic rhinitis. In: Otolaryngology - Head and Neck Surgery 2008; 139(4):565-569.
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