Clinical comparison of systemic methylprednisolone acetate versus topical budesonide in patients with seasonal allergic rhinitis.
Thirty patients with seasonal allergic rhinitis entered a double blind study comparing budesonide (nasal spray, 400 micrograms/d) and i.m. injection of 80 mg methylprednisolone acetate. Symptoms were assessed over a "run in" period of 3-7 days followed by a treatment period of 3 weeks. Pollen counts were evaluated daily. Both the systemic and topical corticosteroid treatment resulted in a significant improvement of nasal and ocular symptoms and were accompanied by reduced antihistamine intake. A comparison of the two treatments in relation to the pollen count yielded statistically significantly fewer nasal symptoms, such as itching, secretion, and sneezing in the budesonide-treated group. Nasal blockage and ocular symptoms remained unchanged, but the use of eyedrops was significantly reduced in the methylprednisolone-treated group. Side effects of both treatments were mild and the incidence negligible. Methylprednisolone-treated patients had a significantly lower cortisol value after 7 days but still had a normal response to ACTH-stimulation. We conclude that the acute symptoms of allergic rhinitis are at least as well ameliorated by regular topical application of budesonide as by a single injection of methylprednisolone acetate. The accompanying allergic conjunctivitis may require additional treatment.
Pichler
W J
WJ
Institute for Clinical Immunology, Bern, Switzerland.
Klint
T
T
Blaser
M
M
Graf
W
W
Sauter
K
K
Weiss
S
S
Witschi
K
K
D000281:Administration, Intranasal; D000287:Administration, Topical; D000336:Aerosols; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D019819:Budesonide; D002985:Clinical Protocols / Q000592:standards*; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D000077555:Methylprednisolone Acetate; D011058:Pollen; D011282:Pregnenediones / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*
D000336:Aerosols; D000893:Anti-Inflammatory Agents; D003692:Delayed-Action Preparations; D011282:Pregnenediones; D000077555:Methylprednisolone Acetate; D019819:Budesonide; D006854:Hydrocortisone; D008775:Methylprednisolone