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Wise et al.

Page 370

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.B.2.a.

Evidence for the role of oral corticosteroids in the management of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Brooks et al. 1247 1993 1b Placebo-controlled, parallel group study SAR during season (n = 31): MP 6, 12, 24 mg QD × 5 days Symptom scores All doses more effective than placebo in reducing symptoms with the highest dose most effective. Bascom et al. 1243 1989 1b Placebo controlled, crossover, nasal challenge study SAR out of season (n = 13): prednisone 60 mg PO daily for 2 days Number of eosinophils and levels of MBP and EDN in nasal lavages Prednisone reduced the number of eosinophils and the levels of its mediators after allergen challenge. Bascom et al. 1242 1988 1b Placebo controlled, crossover, nasal challenge study SAR out of season (n = 10): prednisone 60 mg PO daily for 2 days Number of neutrophils, eosinophils, and mononuclear cells in nasal lavages Prednisone reduced the influx of eosinophils into nasal secretions after allergen challenge. Pipkorn et al. 884 1987 1b Placebo controlled, crossover, nasal challenge study Sneezes, levels of histamine, TAME esterase, kinins, PGD2, LTC4/D4, and albumin in nasal lavages Prednisone inhibited the late-phase response to nasal allergen challenge. Kwaselow et al. 1248 1985 1b Multicenter, randomized, double-blind, placebo controlled study SAR during season (n = 99): 1 Oral flunisolide 500 μ g BID × 4 weeks; 2 Intranasal flunisolide 50 μ g per nostril BID × 4 weeks Symptom scores Intranasal preparation only one to show efficacy in reducing rhinitis symptoms. randomized trial

Symptom scores The groups on steroids had lower symptoms compared to loratadine alone, with no significant difference between them.

2. Loratadine with intranasal MF (200 μ g QD); 2. Loratadine with PO betamethasone 0.25 mg BID Schwartz 1246 1954 4 Observational case series SAR during season (n = 10): Hydrocortisone 40-80 mg daily Symptom relief 7/10 patients reported symptom relief. Schiller & Lowell 1245 1953 4 Observational case series SAR during season (n = 51): cortisone 100 mg daily × 4 days Symptom relief 42/51 patients reported symptom relief. Schwartz et al. 1244 1952 4 Observational case series SAR during season (n = 25): cortisone 100 mg daily × 15 days Symptom relief 21/25 patients reported symptom relief.

1. Loratadine 10 mg daily;

SAR out of season (n = 13): prednisone 60 mg PO daily for 2 days SAR during season (n = 72):

Karaki et al. 1249 2013 2b Open label, parallel,

BID = twice daily; EDN = eosinophil-derived neurotoxin; LOE = level of evidence; LTC4/D4 = leukotriene C4/D4; MBP = major basic protein; MF = mometasone furoate; MP = methylprednisolone; PGD2 = prostaglandin D2; PO = per os (medication taken orally); QD = once daily; SAR = seasonal allergic rhinitis; TAME = N-a-p-tosyl-L-arginine methyl ester.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.