Intranasal corticosteroid administration reduces nonspecific bronchial hyperresponsiveness and improves asthma symptoms.
BACKGROUND
Rhinitis and asthma are currently recognized as manifestations of a single syndrome, the chronic allergic respiratory syndrome. Nearly all individuals with asthma have rhinitis, and severe rhinitis has been associated with worse outcomes in asthma patients. Intranasal treatment has been reported to be beneficial for the lower airways.


METHODS
This was a randomized, double-blind, placebo-controlled study. The objective was to evaluate the effects that treatment with intranasal beclomethasone dipropionate (BDP; 400 microg/d) has on nasal and bronchial symptoms, as well as on lung function test results and bronchial responsiveness to histamine in patients with allergic rhinitis and asthma. We evaluated 33 patients, divided into two groups: treatment (n = 17); and placebo (n = 16). Over the course of the 125-day study period, each patient reported daily rhinitis and asthma symptoms, as well as the need for additional medication. All patients were submitted to spirometry and histamine challenge at baseline and at each subsequent evaluation (on days 50 and 75).


RESULTS
In comparison with the patients in the placebo group, those in the BDP treatment group presented significantly fewer nasal symptoms on day 50 and fewer asthma symptoms on day 75 (p < 0.01 for both); required rescue medications less often; and presented a significantly lower degree of bronchial responsiveness to histamine on day 75 (p < 0.01).


CONCLUSIONS
In this study, intranasal BDP was effective in treating rhinitis as well as asthma. The benefits for the lower airways were observed only after prolonged treatment and might be better evaluated through nonspecific bronchial challenge.
Agondi
Rosana Câmara
RC
Department of Clinical Immunology and Allergy, University of Sao Paulo, Sao Paulo, Brazil.
Machado
Maria Lavínea
ML
Kalil
Jorge
J
Giavina-Bianchi
Pedro
P
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D016535:Bronchial Hyperreactivity / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006632:Histamine; D006801:Humans; D008297:Male; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000188:drug therapy; D055815:Young Adult
D005938:Glucocorticoids; D006632:Histamine; D001507:Beclomethasone