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Nasal Inhalation of Corticosteroids May Top Oral Inhalation for Asthma ControlNEW YORK (Reuters Health) Apr 12 - Nasal inhalation of corticosteroids using a spacer attached to a face mask results in a greater improvement in symptoms of allergic rhinitis and asthma than standard oral inhalation, according to a study published in the current issue of Allergy. Dr. Paolo A. M. Camargos and colleagues at the University of Bahia in Salvador, Brazil conducted an eight-week trial comparing nasal with oral inhalation of fluticasone propionate hydrofluoroalkane. A two-week washout period was planned to follow the active treatment phase, but was halted because of symptom worsening, especially in the oral inhalation group. Thirty patients with allergic rhinitis and asthma used a spacer with a face mask to inhale fluticasone propionate through the nose. They were instructed to keep their mouths closed during drug delivery. Thirty similar patients used the spacer and a mouthpiece to orally inhale the drug. Symptoms of allergic rhinitis and asthma and peak nasal inspiratory flow improved to a greater extent in the nasal inhalation group, "suggesting that nasal deposition is able to open a blocked nose," the investigators observe. They note that "nasal inhalation of an inhaled corticosteroid allows the drug to follow the same pathway of inhaled aeroallergens and irritants," Oral inhalation bypasses parts of the airway most affected by allergens. Progressive improvement in overall symptoms occurred in both groups. The investigators note that the study was powered to assess the effects on nasal symptoms, but underpowered to assess effects on lung function and asthma scores, A lower dose of corticosteroids was able to be used with nasal inhalation In addition, Dr. Camargos' group believes adherence rates may be higher with the nasal route because of the high level of patient acceptance seen in this study. Dr. Camargos and colleagues conclude that "This approach is likely to result in higher compliance, lower costs and fewer side effects" compared with standard oral inhalation of corticosteroids. Allergy 2007;62:310-316.
Current Topic "Plastics in our environment may be making us sick" Allergy
and Asthma Network/Mothers of Asthmatics
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