Should Intranasal Corticosteroids Be Used for the Treatment of Ocular Symptoms of Allergic Rhinoconjunctivitis? A Review of Their Efficacy and Safety Profile

Lightman, Sue; Scadding, Glenis

doi:10.1159/000333100

Cited by 22 publications

(15 citation statements)

References 151 publications

(154 reference statements)

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“…The scoring was also relatively low in the placebo group, which might depend both on the severity of the disease and the pollen exposure. The relief of ocular and bronchial symptoms is considered secondary to the nasal effects in line with the concepts of ‘united airways' [12] and naso-ocular reflex [13]. It might be that a certain threshold of nasal disease is necessary in order to elicit the secondary organ effect and that the very low level of nasal symptoms in the active group largely remained below this hypothetical threshold.…”

Section: Discussionmentioning

confidence: 99%

A Nasally Applied Cellulose Powder in Seasonal Allergic Rhinitis in Adults with Grass Pollen Allergy: A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

Åberg¹,

Ospanova

Nikitin

et al. 2014

Int Arch Allergy Immunol

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Background: A nasally applied cellulose powder is increasingly used in many countries as a remedy for allergic rhinitis. In 2009, a 4-week study in birch pollen-allergic children showed a reduction in nasal symptoms. The best effect occurred on days with lower pollen counts. The present study in grass pollen-allergic adults used the same basic design. Methods: In May 2013, a double-blind, placebo-controlled study was conducted in 108 patients with allergic rhinitis due to grass pollen (18-40 years of age). SMS on mobile phones were used as reminders of treatment and reporting of symptom scores. Results: We found significant reductions in severity scores for sneezing, runny nose, stuffy nose and symptoms from eyes and lower airways, both separately and together (all p < 0.001). Reflective opinion of effect and guess on treatment at follow-up visits (both p < 0.001) confirmed a high efficacy. No clinically significant adverse effects were reported. Conclusions: The product provided significant protection against all seasonal allergic rhinitis symptoms from both upper and lower airways during the grass pollen season in an adult population. The magnitude and scope of efficacy support the use of the product as an early choice in the treatment of allergic rhinitis.

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Section: Discussionmentioning

confidence: 99%

A Nasally Applied Cellulose Powder in Seasonal Allergic Rhinitis in Adults with Grass Pollen Allergy: A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

Åberg¹,

Ospanova

Nikitin

et al. 2014

Int Arch Allergy Immunol

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“…1106 Topical corticosteroid use is also related with mild adverse effects, such as nasal dryness, bleeding, burning sense, and throat irritation. 1153 In conclusion, topical corticosteroid can be used as preoperative treatment for better surgical field. In case of oral corticosteroid, there is no study to evaluate its efficacy as a preoperative agent for CRSsNP.…”

Section: Xc1 Crssnp: Preoperative Corticosteroidsmentioning

confidence: 98%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

548

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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“…According to the World Allergy Organization estimation [1], between 20 and 40% of the world population are affected by allergies. In the recent ‘Allergies in America' survey, >50% of nasal allergy patients stated that tearing and red/itching eyes were moderately to extremely bothersome [2,3,4]. For about of 15% of all nasal allergy sufferers, the ocular component of allergic hypersensitivity reactions was the most bothersome symptom.…”

Section: Introductionmentioning

confidence: 99%

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Gloistein

Astvatsatourov²,

Allekotte³

et al. 2015

Int Arch Allergy Immunol

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Background: Allergic reactions in patients with seasonal or perennial rhinoconjunctivitis mediated by airborne allergens can be effectively assessed with the conjunctival provocation test (CPT). The CPT is a fast and easy diagnostic procedure that challenges the ocular mucosa with instillations of allergen solutions into the conjunctival region. This paper aimed to investigate the possible influence of repeated diagnostic CPT procedures on the patient's clinical presentation, i.e. to analyze desensitization effects caused by diagnostic solutions and to show the reproducibility of CPT results. Methods: Treatment progress in 120 placebo-treated patients from 2 immunotherapeutic dose-finding studies was estimated and documented, as based on the CPT which was applied at 4 visits with intervals of 4, 8 and 16 weeks. High-resolution digital photos collected as part of the CPT documentation were analyzed by an external observer and by digital analysis software to determine conjunctival redness, completely independent of the subjectivity of investigators and patients. Results: Two extremal scenarios of the redness changes were considered after provocation with 10,000 standard quality units/ml. A maximal decrease of about 3% (t test: p = 0.0002; U test: p = 0.001) and a minimal decrease of about 1% (t test: p = 0.254; U test: p = 0.431) were found. Conclusions: The observed decrease in conjunctival hyperemia can be explained by local desensitization or by placebo effect. Due to the setup of both studies considered, we could not ascertain how these factors influence the decrease in redness. In order to attribute the observed effects to local conjunctival desensitization with certainty, further pilot studies are needed.

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Should Intranasal Corticosteroids Be Used for the Treatment of Ocular Symptoms of Allergic Rhinoconjunctivitis? A Review of Their Efficacy and Safety Profile

Cited by 22 publications

References 151 publications

A Nasally Applied Cellulose Powder in Seasonal Allergic Rhinitis in Adults with Grass Pollen Allergy: A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

A Nasally Applied Cellulose Powder in Seasonal Allergic Rhinitis in Adults with Grass Pollen Allergy: A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

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