title: Unified disease, unified management: treating allergic rhinitis and asthma with nasally inhaled corticosteroid.
abstract: Persistent allergic rhinitis (AR) and asthma constitute a common comorbidity. Combined treatment is recommended by prescribing intranasal plus oral inhaled corticosteroids. This study was carried out to assess the efficacy of an alternative regimen to treat this condition. All recruited patients suffered from persistent AR and asthma. Diagnosis and classification of AR and asthma were based on international guidelines. The experimental group received fluticasone propionate (FP), 500microg/day during six weeks, inhaled exclusively through the nose using a valved large volume spacer attached to a face mask. The comparison group also received the same dose of orally inhaled FP, during the same time period, plus intranasal aqueous fluticasone, 200microg/day. There were no statistical differences between both groups regarding AR and asthma severity, clinical scores, acoustic rhinometry, lung function, and FeNO upon admission and during the follow up period. Intragroup analysis demonstrated a significant improvement for allergic rhinitis and asthma scores as well as for FeNO from admission to the sixth week (p<0.01) in both groups. Results suggest that exclusive nasally inhaled fluticasone propionate should be considered as an alternative step in the management of patients suffering from AR and asthma comorbidity.
authors.affiliation: Department of Pediatrics, Medical School, Federal University of Minas Gerais, Avenida Professor Alfredo Balena, 190/Room 267, Belo Horizonte, Brazil.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Ribeiro de Andrade
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Chatkin
authors.forename: Jussara
authors.initials: J
authors.lastname: Fiterman
authors.forename: Noris
authors.initials: N
authors.lastname: Scaglia
authors.forename: Paulo Augusto
authors.initials: PA
authors.lastname: Camargos
mesh_terms: D000280:Administration, Inhalation; D000281:Administration, Intranasal; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000730:Androstadienes / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000730:Androstadienes; D000068298:Fluticasone