Audit of nasal steroid use and effectiveness in a rhinitis clinic.
BACKGROUND
Intranasal corticosteroids are the most effective treatment for allergic rhinitis based on meta-analyses of clinical trials; however, the population in such trials is restricted and may not be representative of patients who are later treated with the medication. The effectiveness of intranasal steroids in the real world has not been assessed.


OBJECTIVE
We asked patients returning to a rhinitis clinic having been treated with intranasal corticosteroids for 3 months to fill in an anonymous questionnaire about their use of this treatment, its effectiveness and any adverse events.


RESULTS
A total of 126 out of 134 patients completed the questionnaire. At least 119 of these had used the intranasal steroid spray; 79% found the sprays helpful, 40% found nasal blockage was reduced and 24% noted reduction of all symptoms. A total of 20% experienced no benefit, 21% noted minor adverse events - the most common being epistaxis in 9%.


CONCLUSIONS
The real world effectiveness and adverse event profile of intranasal steroid sprays is similar in clinical practice to that seen in trials. The number needed to treat to obtain symptomatic benefit is 1.26 and to reduce all symptoms is 4. The number needed to harm is 11. Intranasal steroids are an effective and safe first line treatment for rhinitis.
Scadding
Glenis
G
Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK. g.scadding@ucl.ac.uk
Erkan
Alper Nabi
AN
Chau
Ha
H
Maskell
Scott
S
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002648:Child; D004844:Epistaxis / Q000139:chemically induced; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
D005938:Glucocorticoids