Diagnosis and Management of Rhinitis: Complete Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology

Dykewicz, Mark S.; Fineman, Stanley; Skoner, David P.; Nicklas, Richard A.; Lee, Rufus E.; Blessing-Moore, Joann; Li, James T.; Bernstein, I. Leonard; Berger, William; Spector, Sheldon L.; Schuller, Diane E.

doi:10.1016/s1081-1206(10)63155-9

Cited by 609 publications

(537 citation statements)

References 187 publications

Supporting

Mentioning

499

Contrasting

Unclassified

Order By: Relevance

“…[23][24][25][26] To minimize the risks of systemic corticosteroid exposure, including growth suppression, dose-reduction strategies (eg, allergen-avoidance measures, immunotherapy and concomitant treatment with antihistamines, or decongestants) should be considered. 27 In addition, many allergic rhinitis patients also receive corticosteroids via other routes for the treatment of concomitant disorders, such as asthma or atopic dermatitis. Therefore, physicians should take into account the patient's total corticosteroid exposure when prescribing an intranasal corticosteroid and should titrate each patient to the lowest effective dose for each route to minimize systemic exposure.…”

Section: Discussionmentioning

confidence: 99%

Detection of Growth Suppression in Children During Treatment With Intranasal Beclomethasone Dipropionate

Rachelefsky²,

et al. 2000

View full text Add to dashboard Cite

ABSTRACT. Objective. Intranasal beclomethasone dipropionate (BDP) has generally been considered to have no systemic activity at recommended doses, but the potential for long-term effects on growth has not previously been evaluated. This study was undertaken to assess the effects of 1 year of treatment with intranasal BDP on growth in children.Study Design. In this double-blind, randomized, parallel-group study, 100 prepubertal children 6 to 9 years old with perennial allergic rhinitis were treated with aqueous BDP 168 g twice daily (n ‫؍‬ 51) or placebo (n ‫؍‬ 49) for 1 year. Subjects' baseline heights were required to be between the 5th and 95th percentile, and skeletal age as determined by left wrist radiograph was required to be within 2 years of chronological age. Washout periods for medications known to affect growth, including other forms of corticosteroids, were established, and these medications were prohibited during the study. However, short courses of oral prednisolone lasting no more than 7 days, and short courses of dermatologic corticosteroids lasting no more than 10 days, were allowed. Height was measured with a stadiometer after 1, 2, 4, 6, 8, 10, and 12 months of treatment. The hypothalamic-pituitary-adrenocortical axis was assessed by measurements of 8 AM basal cortisol concentrations and response to .25 mg cosyntropin stimulation.The primary safety parameter was the rate of change in standing height. Statistical analyses were based on all randomized subjects who received at least 1 dose of medication (intent-to-treat principle). The rate of change in standing height was analyzed for all subjects who entered the study and for those completing the full 12 months of treatment (n ‫؍‬ 80). The rate of change in standing height over the 1-year study was calculated as the slope of a linear regression line fitted to each subject's height measurements over time. Because there was a statistically significant between-group difference in standing height at baseline, an analysis of covariance was performed for all analyses of standing height data.Results. Of the 100 subjects enrolled, 90 completed the study. The 2 treatment groups were generally comparable at baseline; however, at baseline, mean age and mean height were significantly greater in the BDP treatment group that the in placebo treatment group. In both analyses, overall growth rate was significantly slower in BDP-treated subjects than placebo-treated subjects. The mean change in standing height after 1 year was 5.0 cm in the BDP-treated subjects compared with 5.9 cm in the placebo-treated subjects. The difference in growth rates was evident as early as the 1-month treatment visit, suggesting that the effect on growth occurred initially.The growth-suppressive effect of BDP remained consistent across all age and gender subgroups, and among subjects with and without a previous history of corticosteroid use. Use of additional exogenous corticosteroids during the study was similar in both groups and did not affect the results.Because there was a basel...

show abstract

Section: Discussionmentioning

confidence: 99%

Detection of Growth Suppression in Children During Treatment With Intranasal Beclomethasone Dipropionate

Rachelefsky²,

et al. 2000

View full text Add to dashboard Cite

show abstract

“…This "superiority" is principally related to their effect on nasal obstruction. (1,8,34) Intranasal corticosteroids seem to be among the most efficacious agents for the control of nasal obstruction secondary to AR. In view of the significant impact that nasal obstruction has on sleep quality, the efficacy of intranasal corticosteroids in promoting the relief of nasal congestion suggests that these agents reduce the frequency of sleep disorders and thus the daytime sleepiness associated with such disorders.…”

Section: Allergic Rhinitis: Indicators Of Quality Of Lifementioning

confidence: 99%

“…(33) It is estimated that the total economic burden of AR in children is greater than US$ 5 billion/year. (34) It is of note that, as the incidence of allergic diseases continues to increase, their economic impact also continues to grow.…”

Section: Allergic Rhinitis: Indicators Of Quality Of Lifementioning

confidence: 99%

“…In addition, oral decongestants have stimulating properties that can cause insomnia and agitation. (1,9,34) The cysteine leukotrienes are important inflammatory mediators that are involved in the immediate and late allergic response. The receptor antagonists of cysteine leukotrienes, such as montelukast, compete with the leukotrienes for receptors, which accounts for their effects.…”

Section: Comorbiditiesmentioning

confidence: 99%

See 1 more Smart Citation

Rinite alérgica: indicadores de qualidade de vida

Camelo-Nunes

Solé

2010

J. bras. pneumol.

View full text Add to dashboard Cite

The objective of this review was to present evidence of the relationship between allergic rhinitis and impairment of quality of life. The data sources were original articles, reviews and consensus statements entered into the Medline and LILACS databases between 1997 and 2008. The following search terms were used: "allergic rhinitis"; "quality of life"; and "sleep disorders". Quality of life is often impaired in patients with allergic rhinitis, due to the classic symptoms of the disease (sneezing, pruritus, rhinorrhea and nasal obstruction). In addition, the pathophysiology of allergic rhinitis often disrupts sleep, leading to fatigue, irritability, memory deficits, daytime sleepiness and depression. The total burden of this disease goes beyond impairment of physical and social functioning. It has also a financial impact, which becomes greater when we consider the evidence that allergic rhinitis is a possible causal factor of comorbidities, such as asthma and sinusitis. Nasal obstruction, the most prominent symptom, is associated with sleep disorders, which can have a profound effect on mental health, learning, behavior and attention. Finally, allergic rhinitis-a chronic condition that affects adults, adolescents and children-is often underdiagnosed or inadequately treated. The deleterious impact that allergic rhinitis-related sleep disorders have on patient capacity to perform activities of daily living is an important component of the morbidity of the disease. With an accurate diagnosis, there are various available treatments that can reduce the burden of allergic rhinitis.Keywords: Rhinitis, allergic, perennial; Rhinitis, allergic, seasonal; Quality of life; Sleep disorders. ResumoO objetivo desta revisão foi apresentar evidências da relação entre rinite alérgica e redução da qualidade de vida. As fontes de dados foram artigos originais, revisões e consensos indexados nos bancos de dados Medline e LILACS entre 1997 e 2008. As palavras de busca foram "rinite alérgica", "qualidade de vida" e "distúrbios do sono". Os pacientes com rinite alérgica frequentemente têm redução na qualidade de vida causada pelos sintomas clássicos da doença (espirros, prurido, coriza e obstrução). Além disso, a fisiopatologia da rinite alérgica, com frequência, interrompe o sono, ocasionando fadiga, irritabilidade, déficits de memória, sonolência diurna e depressão. A carga total da doença recai não apenas no funcionamento social e físico prejudicados, mas também no impacto financeiro, que se torna maior quando se consideram as evidências de que a rinite alérgica é um possível fator casual de comorbidades, tais como a asma e a sinusite. A obstrução nasal, o mais proeminente dos sintomas, está associada a eventos respiratórios relacionados aos distúrbios do sono, uma condição que tem profundo efeito sobre a saúde mental, o aprendizado, o comportamento e a atenção. Finalmente, a rinite alérgica -doença crônica que afeta crianças, adolescentes e adultos -frequentemente é subdiagnosticada ou inadequadamente tratada. O impacto dele...

show abstract

“…55 Guidelines provide evidence-based recommendations to inform the management of allergic rhinitis under the headings 'allergen avoidance', 'pharmacological treatment', and 'specific immunotherapy'. 55,[109][110][111] Allergen avoidance can be effective for reducing the symptoms of allergic rhinitis, [112][113][114][115] though single interventions may be insufficient to control symptoms. 116 Non pharmacological measures with some efficacy include saline douches, 55,117-120 rhinophototherapy, 121 nasal filters, 122 pollen-blocker creams, 123 or cellulose powder.…”

Section: Managementmentioning

confidence: 99%

The International Primary Care Respiratory Group (IPCRG) Research Needs Statement 2010

Pinnock

Thomas

Tsiligianni

et al. 2010

Primary Care Respiratory Journal

View full text Add to dashboard Cite

Diagnosis and Management of Rhinitis: Complete Guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology

Cited by 609 publications

References 187 publications

Detection of Growth Suppression in Children During Treatment With Intranasal Beclomethasone Dipropionate

Detection of Growth Suppression in Children During Treatment With Intranasal Beclomethasone Dipropionate

Rinite alérgica: indicadores de qualidade de vida

The International Primary Care Respiratory Group (IPCRG) Research Needs Statement 2010

Contact Info

Product

Resources

About