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Wise et al.

Page 371

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.B.2.b.

Evidence for the role of corticosteroid injections in the management of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Yang et al. 1262 2008 1b Randomized, placebo-controlled single-blind trial Patients with PAR received intraturbinate injections (n = 39): 1 Onabotulinum toxin A (25 units in each turbinate); 2 Triamcinolone (20 mg, 1 mL in each turbinate); 3 Isotonic saline (1 mL in each turbinate) Symptoms of rhinorrhea, nasal obstruction, sneezing and itching at 1, 4, 8, 12, 16, and 20 weeks after injections onabotulinum toxin A controlled nasal symptoms for the longest time after injection. Steroid injection was better than placebo but the duration of action was shorter than onabotulinum toxin A. Laursen et al. 1253 1988 1b Double blind, double dummy, placebo controlled, study SAR during season (n = 30): 1 Intranasal beclomethasone dipropionate (400 μ g daily) for 4 weeks; 2 IM injection of 2 mL betamethasone dipropionate/betamethasone disodium phosphate at start of season Rhinoconjunctivitis symptom scores IM injection significantly more effective than placebo or intranasal preparation. Borum et al. 1254 1987 1b Double-blind, placebo controlled, parallel study during 2 consecutive pollen seasons SAR during 2 consecutive allergy seasons (n = 24): 1 IM injection of 80 mg methylprednisolone given either at the beginning of the season or at peak pollen count; 2 Placebo Number of sneezes and nose blowing during the day. Symptom scores of sneezing, rhinorrhea, nasal blockage, eye itching recorded at the end of the day. IM injection was efficacious against nasal congestion with less pronounced effects against rhinorrhea and sneezing in active vs placebo treatment irrespective of timing of administration. Laursen et al. 1252 1987 2b Randomized, double-blind comparative SAR during season (n = 37):

IM and oral steroid resulted in a significant reduction of nasal/ocular symptoms during season. Significant suppression of adrenal function with oral steroid treatment only.

All treatments led to significant reductions in nose and eye symptoms during season; no

difference between groups. All preparations suppressed endogenous cortisol; 2 out of 3 injections caused increases in blood sugar levels.

Both preparations led to a significant reduction of nose and eye symptoms; betamethasone combination was more effective.

Nasal peak flow and symptom scores. ACTH test performed at 3 weeks.

Scores of rhinorrhea, congestion, and ocular symptoms at 1, 2, and 4 weeks after injection. Cortisol and glucose blood levels in 38 subjects.

Weekly nasal and ocular symptoms for 5 weeks

1 Oral prednisolone 7.5 mg PO daily × 3 weeks; 2 Single IM injection of 2 mL betamethasone dipropionate/betamethasone disodium phosphate at start of season

1 2 mL betamethasone dipropionate/ betamethasone phosphate (5 and 2 mg/mL);

SAR during season (n = 60). Received 1 of 3 long-acting IM injections: 1 Betamethasone dipropionate (5 mg); 2 Betamethasone disodium phosphate (3 mg)/ acetate (3 mg); 3 Methylprednisolone acetate (40 mg)

SAR during season. IM injection at season onset (n = 42):

randomized,

parallel group

parallel,

randomized, open label

1980 2b Prospective,

Kronholm 1250 1979 2b Prospective,

Ohlander et al. 1251

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