xRead - September 2022

Wise et al.

Page 376

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE IX.B.2.c-2.

Effect of intranasal corticosteroids on comorbidities: ocular symptoms and asthma Study Year LOE Study design Study groups Clinical endpoint Conclusion Lohia et al. 1296 2013 1a SR and meta-analysis Asthma and AR. 18 studies (n = 2162). Efficacy of INCS on asthma outcomes. Asthma outcomes: pulmonary function, bronchial reactivity, asthma symptom scores, asthma-specific QOL, and rescue medication use. Use of INCS resulted in significant improvements in FEV1, bronchial challenge, asthma symptom scores, and rescue medication use vs placebo. INCS improved morning and evening PEF. Addition of INCS spray to orally inhaled corticosteroids did not result in additional improvement. Bielory et al. 1291 2011 1a Meta-analysis of placebo-controlled RCTs 10 studies (n = 3132). SAR: 6 studies; PAR: 4 studies; MFNS 200 μ g daily. Severity of reflective ocular symptoms (itching/burning, redness, and tearing/ watering) on a 4-point scale over 12 hours. Overall treatment effect was significant for all 3 individual ocular symptoms in SAR and PAR studies. DeWester et al. 1290 2003 1a Retrospective analysis of multicenter, RDBPCTs 7 studies. Efficacy of FPNS 200 μ g daily for nasal and ocular symptoms in patients with SAR. Mean change from baseline in the clinician-rated TOSS (itching, tearing, redness, and puffiness) at 7 and 14 days of therapy. FPNS group had significantly greater mean changes from baseline in the TOSS and in all 4 individual symptom scores vs placebo at days 7 and 14. Taramarcaz & Gibson 1295 14 studies (n = 477). INCS vs placebo/routine asthma treatment. Asthma outcomes: symptom scores, FEV1, PEF, and methacholine airway responsiveness. No statistically significant benefit of INCS in asthma. Ratner et al. 1292 2015 1b Randomized, double blind, parallel, multicenter study SAR (n = 614). FPNS 200 μ g daily vs placebo × 14 days. Mean change from baseline in patient rated rTOSS. controlled, crossover trial SAR out of season (n = 20). FFNS 110 μ g daily vs placebo × 1 week.

FPNS was significantly more efficacious in reducing the ocular symptoms of AR vs placebo.

Pretreatment with FFNS significantly reduced eye symptoms after nasal allergen challenge.

Nasal and ocular symptoms after allergen challenge.

Nasal allergen challenge.

2003 1a Meta-analysis of RCTs Asthma and AR.

Baroody et al. 1293 2009 1b Double-blind, placebo

AR = allergic rhinitis; FEV1 = forced expiratory volume in 1 second; FFNS = fluticasone furoate nasal spray; FPNS = fluticasone propionate nasal spray; INCS = intranasal corticosteroid; LOE = level of evidence; MFNS = mometasone furoate nasal spray; PAR = perennial allergic rhinitis; PEF = peak expiratory flow; QOL = quality of life; RCT = randomized controlled trial; RDBPCT = randomized double-blind placebo-controlled trial; rTOSS = reflective Total Ocular Symptom Score; SAR = seasonal allergic rhinitis; SR = systematic review; TOSS = Total Ocular Symptom Score.

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