A dose-ranging study of mometasone furoate aqueous nasal spray in children with seasonal allergic rhinitis☆☆☆★

Meltzer, Eli O.; Berger, William; Berkowitz, Ruth; Bronsky, Edwin A.; Dvorin, Donald J.; Finn, Albert F.; Galant, Stanley P.; Grossman, Jay; Hampel, Frank C.; Ratner, Paul H.; Ruff, Michael E.; Schenkel, Eric; Segal, Allen T.; Segall, Nathan; Stewart, George E.; Tripathy, Ita; Skoner, David P.; Anolik, Robert; Dockhorn, Robert J.; Bavel, Julius van; Mesarina-Wicki, Barbara; Nolop, K. B.

doi:10.1016/s0091-6749(99)70121-1

Cited by 64 publications

(51 citation statements)

References 15 publications

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“…One study included both postintervention and postnasal challenge measurements (17). Consequently, 17 evaluations on TNSS were included (10 interventional studies comparing MFNS vs placebo for the treatment of AR in 1878 adults (17-19, 21, 49-54); one RCT evaluating 271 children (24); five studies assessing postchallenge effects on TNSS in 634 participants (17,(55)(56)(57)(58) and one study commenced treatment 4 weeks preseasonally (n = 215) (20). Data on the individual nasal symptom scores were available in seven studies including 1582 subjects (19,21,(49)(50)(51)(52)54).…”

Section: Search Resultsmentioning

confidence: 99%

“…There is no clinical evidence that MFNS suppresses the function of the hypothalamic-pituitary-adrenal axis when the drug is administered at clinically relevant doses (100-400 lg/day) (14,23), and there are no reports of any influence on childrenÕs growth (24)(25)(26). Finally, histological studies after long-term use of MFNS have shown no signs of atrophy of the nasal mucosa (27).…”

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confidence: 99%

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Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Penagos

Compalati

Tarantini

et al. 2008

Allergy

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Rationale: Several randomized, double‐blind, placebo‐controlled clinical trials have demonstrated the efficacy of mometasone furoate nasal spray (MFNS) in the treatment of allergic rhinitis (AR) thus allowing for a meta‐analysis to determine the overall treatment effect.Methods: A comprehensive search of the MEDLINE, LILACS, SCOPUS, and the Cochrane Library databases up to 31 October, 2007 was carried out. Randomized, double‐blind, placebo‐controlled, clinical trials evaluating the efficacy of MFNS in patients with AR compared to placebo were included. Total nasal symptom scores (TNSS), individual nasal symptoms, total non‐nasal symptom scores (TNNSS) and nasal airflow were analysed as the standardized mean difference (SMD). Meta‐analysis was performed with the random or the fixed effect models depending on heterogeneity, by using revman 5 software.Data synthesis: Sixteen of the 113 identified articles met the inclusion criteria. For MFNS efficacy on TNSS, 2998 participants were analysed: 1534 received MFNS and 1464 placebo. Mometasone furoate nasal spray was associated with a significant reduction in TNSS (SMD −0.49, 95% CI: −0.60 to −0.38; P < 0.00001; I2 = 50.1%). A significant effect on SMD for nasal stuffiness/congestion (−0.41; 95% CI: −0.56 to −0.27), rhinorrhoea (−0.44; 95% CI: −0.66 to −0.21), sneezing (−0.40; 95% CI: −0.57 to −0.23) and nasal itching (−0.39; 95% CI: −0.53 to −0.25) was also demonstrated. Mometasone furoate nasal spray treated subjects also showed a significant reduction in TNNSS (−0.30; 95% CI: −0.43 to −0.18). The proportion of patients with adverse events was similar for MFNS and placebo (0.99; 95% CI: 0.81–1.20; P = 0.91).Conclusions: This meta‐analysis provides a level Ia evidence for the efficacy of MFSN in the treatment of AR vs placebo. Adverse events frequency was similar in both groups.

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Section: Search Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Penagos

Compalati

Tarantini

et al. 2008

Allergy

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“…Pediatric studies have assessed growth suppression as well as adrenocortical suppression and bone metabolism. [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] Intranasal corticosteroids in current use have minimal systemic effects due to low bioavailability. 64 …”

Section: Intranasal Corticosteroidsmentioning

confidence: 99%

Management of Allergic Rhinitis

Sausen

Marks

Sausen

et al. 2005

The Journal of Pediatric Pharmacology and Therapeutics

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ABBREVIATIONS: EIB, exercise-induced bronchospasm; IL4, interleukin 4; IL5, interleukin 5; MFNS, mometasone furoate nasal spray; RANTES, regulated upon activation normal T-cell expressed and secreted; QOL, quality of life Allergic rhinitis is the most common chronic childhood disease. Reduced quality of life is frequently caused by this IgE-mediated disease, including sleep disturbance with subsequent decreased school performance. Asthma and exercise-induced bronchospasm are commonly seen concurrently with allergic rhinitis, and poorly controlled allergic rhinitis negatively affects asthma outcomes. Nonsedating antihistamines or intranasal azelastine are effective agents to manage allergic rhinitis, often in combination with oral decongestants. For moderate to severe persistent disease, intranasal corticosteroids are the most effective agents. Some patients require concomitant intranasal corticosteroids and nonsedating antihistamines for optimal management. Other available agents include leukotriene receptor antagonists, intranasal cromolyn, intranasal ipratropium, specific immunotherapy, and anti-IgE therapy.

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“…Nos pacientes com sinusite crônica/recorrente em que a rinite alérgica esteja sintomática recomenda-se o uso de corticosteróides tópicos nasais 7,108,109 . Como a corticoterapia é imunossupressora, a infecção concomitante já deverá estar controlada.…”

Section: Diagnóstico E Conduta Nos Casos Crônicos E Recorrentesunclassified

“…Esse produto mostrou incidência de efeitos colaterais semelhante à do placebo em estudos clínicos de tolerabilidade, que avaliaram crianças com rinite alérgica de idade entre três e doze anos [109][110] . A apresentação aquosa de alguns desses esteróides nasais é melhor tolerada pelas crianças 79,91,106,109 . Outra opção de corticosteróide tópico é a budesonida que pode ser utilizada para crianças com idade entre dois e quatro anos, na forma de uma borrifada (puff) em cada narina duas vezes ao dia, durante um mês.…”

Section: Diagnóstico E Conduta Nos Casos Crônicos E Recorrentesunclassified

Diagnosis and therapeutic management of sinusitis in children

Ejzenberg¹,

Sih²,

Haetinger³

1999

J Pediatr (Rio J)

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ResumoObjetivo: Revisar os principais aspectos relativos a diagnóstico e conduta frente à suspeita de sinusite em crianças, segundo a literatura pertinente.Método: Levantamento bibliográfico.Resultado: São estabelecidos critérios de suspeita clínica da patologia, de indicação de exames microbiológicos e radiográficos, assim como da abordagem medicamentosa e cirúrgica para as diferentes situações clínicas em que a sinusite é diagnosticada.Conclusões: A padronização de condutas clínicas frente à sinusite da criança permite uma otimização na suspeita, no diagnós-tico, na solicitação de exames comprovatórios assim como na utilização de antimicrobianos e outros fármacos e na cirurgia em casos selecionados. AbstractObjective: The authors review the main aspects related to the diagnosis and management of sinusitis in children, according to the medical literature.Methods: Literature review.Results: Clinical criteria, microbiology, image diagnosis, medical and surgical management are presented, whenever sinusitis is considered.Conclusions: The standardization of the clinical approach in children's sinusitis allows optimization of the diagnosis and the appropriate subsidiary exams, as well the correct use of antimicrobials and others drugs, or surgery in selected cases. IntroduçãoAs sinusites constituem, dentro das doenças da via aérea superior, um grupo peculiar, de difícil comprovação, avaliação fisiopatológica e etiológica e, conseqüente-mente, um problema para uma adequada intervenção terapêutica 1,2 . Diferentemente das doenças da cavidade oral e da orelha média, as cavidades paranasais não podem ser observadas diretamente ao exame físico 3-5 . A coleta de material local para exame, tão recomendada para comprovação de infecções faríngeas, também não é realizável rotineiramente 4 . A avaliação causal também é difícil, pois diferentes agentes químicos (partículas de combustão, gases, pólen) e infecciosos podem originar inflamação sinusal [6][7][8] . Muitas vezes esses agravos são simultâneos ou seqüenciais, como as infecções bacterianas que se associam a inflamações rinossinusais alérgicas ou virais 8 . Além dessas dificuldades iniciais na avaliação das sinusites, há também outras durante a evolução do quadro, em que são também limitadas as possibilidades de avaliação da resolução/agravamento da inflamação local, esterilização da cavidade e mucosa, assim como reconhecimento dos casos com retenção de secreções sinusais (obstrução ostial) 9-11 . Esse conjunto de incertezas tem se prestado a interpretações diversas quanto à ocorrência das sinusites e ao estabelecimento de critérios diagnósticos e terapêuti-cos [12][13][14] .Por todos esses motivos, as sinusites estão há décadas no centro dos debates pediátricos, otorrinolaringológicos, e radiológicos, recentemente reavivados [15][16][17][18] . Isso decorreu da preocupação com a progressiva resistência antibiótica das bactérias, em que um significativo fator implica-

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A dose-ranging study of mometasone furoate aqueous nasal spray in children with seasonal allergic rhinitis☆☆☆★

Cited by 64 publications

References 15 publications

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Management of Allergic Rhinitis

Diagnosis and therapeutic management of sinusitis in children

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