Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
9226984 | Journal of Allergy and Clinical Immunology | 2005 | 24 Pages |
Abstract
Although administered at low doses, intranasal steroids still have the potential for systemic absorption and adverse consequences. However, it is appreciated that meaningful differences exist in the bioavailability of different steroid molecules, and although a small but statistically significant effect on growth in children has been identified with the long-term use of intranasal beclomethasone when administered twice daily for 1 year, this is not evident with all intranasal steroids. In addition, twice-daily intranasal steroid administration may have more effect-from the endocrinologic perspective-than once-daily administration in the morning, which coincides better with the natural diurnal variation in cortisol. Thus, once-daily intranasal steroid administration is preferable, and when used in studies in children, measurement of height change during the study period is an important outcome variable together with other indices of systemic steroid bioavailability (eg, tests of hypothalamic-pituitary-adrenal axis function). These considerations have even greater relevance if children are concurrently also receiving inhaled steroids for asthma, because the total steroid load will be greater.
Keywords
Medical Outcomes Survey Short Form 36HRQLICSSF-36QTcQOLBMDSTTSystemic side effectsPEARQLQFDAAMLQT interval corrected for heart rateINSSARQuality of lifeUPSITClinical trialsAllergyH1-antihistaminesUS Food and Drug AdministrationIntranasal steroidsphenyl ethyl alcoholMRIolfactionBone mineral densityMagnetic resonance imagingPositron emission tomographyUniversity of Pennsylvania Smell Identification TestCNSGrowthRhinitisCardiotoxicitycentral nervous systemSeasonal allergic rhinitisBone metabolismHPA axisHPAhypothalamic-pituitary-adrenalPETQuestionnaireRhinoconjunctivitis Quality of Life QuestionnaireChildrenInhaled corticosteroidHealth-related quality of life
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Authors
Elizabeth F. MCSP, MSc, Elisabeth PhD, Richard L. MD, PhD, F. Estelle R. MD, FRCPC, David B. MD, Peter H. BSc (Hons), DM, FRCP,