HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (14) Citing Articles via Google Scholar Google Scholar Articles by Stelmach, R. Articles by Cukier, A. Search for Related Content PubMed PubMed Citation Articles by Stelmach, R. Articles by Cukier, A.

Effect of Treating Allergic Rhinitis With Corticosteroids in Patients With Mild-to-Moderate Persistent Asthma^*

^* From the Division of Respiratory Diseases (Drs. Stelmach, Ribeiro, and Cukier), Heart Institute (InCor), and the Division of General Internal Medicine (Dr. Nunes), University of São Paulo School of Medicine, São Paulo, Brazil.

Correspondence to: Rafael Stelmach, MD, Itapeva 500-4C, Bela Vista 01332-000-São Paulo/SP, Brazil; e-mail: pnerafael{at}incor.usp.br

Study objectives: Rhinitis and asthma are considered to be synchronic or sequential forms of the same allergic syndrome. Treating the inflammation associated with allergic rhinitis influences the control of asthma. However, few studies have investigated the effect of treating perennial rhinitis on persistent asthma and vice versa. We determined the effects of inhaled or topical nasal beclomethasone dipropionate (BDP) administered separately or in combination on the control of asthma and bronchial hyperresponsiveness (BHR) in patients with the rhinitis/asthma association.

Design: A double-blind, parallel, three-group study.

Setting: Outpatient clinic of Pulmonary Division/Heart Institute (InCor) and the Division of General Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil.

Patients: Seventy-four patients with mild-to-moderate asthma and allergic rhinitis (median age, 25 years).

Interventions: Patients received nasal or inhaled BDP separately or in combination for 16 weeks after a 2-week placebo run-in period.

Measurements and results: Nasal and pulmonary symptoms, as well as pulmonary function and BHR, were compared among the three groups after 4 weeks and 16 weeks of treatment. Patients in all three groups demonstrated a progressive and significant decrease in nasal and pulmonary symptoms, which started after 4 weeks (p < 0.05) and continued through the end of treatment (p < 0.001). Clinical improvement was similar and parallel in the three groups. Asthma-related morbidity, evaluated by quantifying absence from work, emergency department visits, and nighttime awakenings, also decreased in the three groups (p < 0.05).

Conclusions: Failure to consider treatment of rhinitis as essential to asthma management might impair clinical control of asthma. Furthermore, these data suggest that asthma and rhinitis in some patients can be controlled by the exclusive use of nasal medication.

Key Words: allergy • asthma • bronchial reactivity • inhaled corticosteroids • rhinitis

This article has been cited by other articles:

				J Dvorak, N Feddermann, and K Grimm Glucocorticosteroids in football: use and misuse Br. J. Sports Med., July 1, 2006; 40(suppl_1): i48 - i54. [Abstract] [Full Text] [PDF]