Inhaled and nasal corticosteroids: safety aspects*

Passalacqua, G.; Albano, M.; Canonica, Giorgio Walter; Bachert, Claus; Cauwenberge, Paul Van; Davies, Robert J.; Durham, S.R.; Kontou-Fili, Kalliopi; Horak, Friedrich; Malling, Hans‐Jørgen

doi:10.1034/j.1398-9995.2000.00370.x

Cited by 101 publications

(58 citation statements)

References 228 publications

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“…17,18 The relative ocular safety of intra nasal steroids is supported in a longer term study by Bernstein in which patients treated with mometasone furoate nasal spray showed no clinically significant increase in intraocular pressure (IOP) or risk of subcapsular cataracts. 19 There is also some concern regarding the safety and systemic absorption of intra nasal steroids and the possibility of suppression of the hypothalamus-pituitaryadrenal axis.…”

mentioning

confidence: 86%

A randomized study comparing the efficacy of mometasone furoate and fluticasone furoate on the ocular and nasal symptoms of allergic rhinitis

Bakshi

Gopalakrishnan

Coumare

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Ocular symptoms like itching, redness and congestion are common in patients with allergic rhinitis. These symptoms affect the quality of life and increase the burden on the healthcare cost. Intranasal steroids are effective in reducing the nasal and ocular symptoms of allergic rhinitis. We aim to compare the efficacy of mometasone furoate nasal spray and fluticasone furoate nasal spray in reducing the nasal and ocular symptoms of allergic rhinitis.Methods: 90 patients with perennial allergic rhinitis and ocular symptoms were randomly divided into 2 groups. Group A (n=46) received 200 µg of mometasone furoate nasal spray once daily and Group B (n=44) received 110 µg of fluticasone furoate nasal spray daily. The patients were assessed by total ocular symptom score [TOSS] and total nasal symptom score [TNSS] at 2, 6 and 12 weeks interval. Results: There was a statistically significant reduction in both the groups in respect to the TOSS and TNSS scores. However the improvement in the TOSS score in the fluticasone furoate group was more than the mometasone furoate group by 6 weeks (p=0.0009), which continued till the 12 weeks (p=0.045).Conclusions: Fluticasone furoate is more effective than mometasone furoate in managing the ocular and nasal symptoms of allergic rhinitis.

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mentioning

confidence: 86%

A randomized study comparing the efficacy of mometasone furoate and fluticasone furoate on the ocular and nasal symptoms of allergic rhinitis

Bakshi

Gopalakrishnan

Coumare

2017

Int J Otorhinolaryngol Head Neck Surg

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“…ICS exert their clinical and anti-infl ammatory actions depending on a wide range of variables, including the status of the nasal and bronchial wall (Laitinen 1994;Barnes 1995;Kraft et al 1996), the pharmacodynamic-pharmacokinetic properties of the drug (Andersson and Ryrfeldt 1984;English et al 1994;Miller-Larson et al 1994;Lipworth 1995;Johnson 1996), the delivery system (Brown et al 1990;Selroos and Halme 1991;Smith et al 1995;Pedersen 1996), the patient's cooperation (Toogood et al 1984;Pedersen et al 1986;Lindgren et al 1987;Newman et al 1991), and the dosage regimen (Munch et al 1982;Pincus et al 1995;van Schayck et al 1995;Bernstein et al 2004). These factors also determine the severity and frequency of side-effects (Passalacqua et al 2000).…”

Section: Mechanism Of Action Of Icsmentioning

confidence: 99%

“…BDP, for which more data are available, should be preferred; nevertheless, no actual teratogenicity in men has ever been reported. No specifi c study has been conducted on ICS and lactation (Passalacqua et al 2000).…”

Section: Side-effectsmentioning

confidence: 99%

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New treatment options in allergic rhinitis: patient considerations and the role of ciclesonide

Braido

Lagasio²,

Piroddi³

et al. 2008

TCRM

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Allergic rhinitis (AR) is a chronic infl ammatory respiratory disease affecting 5%-50% of the worldwide population and its prevalence is increasing (Herman 2007). In addition, AR is associated with asthma and other co-morbidities such as conjunctivitis and sinusitis. The main symptoms are nasal congestion, rhinorrea, sneezing, itching, and post-nasal drainage induced after allergen exposure by an IgE-mediated infl ammation of the membranes lining the nose. AR is not a life-threatening disease, but it has been shown to have a signifi cant impact on quality of life. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines propose a classifi cation of AR in intermittent and persistent, each graded as mild or moderate-severe, and provide a stepwise approach to the treatment. Inhaled steroids and antihistamine are the main tools in AR therapy but more safe and effective drugs are, however, needed. Inhaled steroid ciclesonide appears to be safe and effective.

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“…14,15 Acute asthma episodes are a particular concern in pregnant women because they can significantly decrease fetal oxygenation. 16,17 Severe or uncontrolled asthma is associated with adverse maternal complications (including preeclampsia, vaginal hemorrhage, and complicated labor) and adverse fetal outcomes (including perinatal mortality, intrauterine growth restriction, preterm birth, low birth weight, and neonatal hypoxia). 1,14,18 Conversely, women with well-controlled asthma and appropriate treatment have little or no increased risk of adverse maternal or fetal outcomes.…”

Section: Effects Of Asthma and Ar On Pregnancymentioning

confidence: 99%

Treating Asthma and Comorbid Allergic Rhinitis in Pregnancy

Yawn¹,

Knudtson²

2007

The Journal of the American Board of Family Medicine

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Women with severe or uncontrolled asthma are at higher risk for pregnancy complications and adverse fetal outcomes than women with well-controlled asthma. Recent evidence-based guidelines have concluded that it is safer for pregnant women with asthma to be treated pharmacologically than to continue to have asthma symptoms and exacerbations. According to the Asthma and Pregnancy Working Group (APWG) of the National Asthma Education and Prevention Program, optimal treatment of asthma during pregnancy includes treatment of comorbid allergic rhinitis (AR), which can trigger or aggravate asthma symptoms. In general, treatment of both asthma and AR during pregnancy should follow the same stepwise approach that is used in the general population. This article presents the specific recommendations from the most recent APWG report and from other systematic reviews about which asthma and allergic rhinitis drugs should be preferred during pregnancy. Of the corticosteroids, budesonide has the most data and is listed as Pregnancy Category B (no evidence of risk in humans). Other inhaled and intranasal corticosteroids have less data and are listed as Pregnancy Category C but may be continued during pregnancy if the patient's asthma was well controlled with the medication before pregnancy.

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Inhaled and nasal corticosteroids: safety aspects*

Cited by 101 publications

References 228 publications

A randomized study comparing the efficacy of mometasone furoate and fluticasone furoate on the ocular and nasal symptoms of allergic rhinitis

A randomized study comparing the efficacy of mometasone furoate and fluticasone furoate on the ocular and nasal symptoms of allergic rhinitis

New treatment options in allergic rhinitis: patient considerations and the role of ciclesonide

Treating Asthma and Comorbid Allergic Rhinitis in Pregnancy

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