Influence of intranasal steroids during the grass pollen season on bronchial responsiveness in children and young adults with asthma and hay fever
B J Thioa, G L M Slingerlanda, A M Fredriksa, A F Nagelkerkea, R A Scheerenb, H J Neijensc, J J Roorda, J E Dankert-Roelsea
a Department of
Pediatrics, University Hospital, Academisch Ziekenhuis van de Vrije
Universiteit, Amsterdam, The Netherlands, b Department of
Otolaryngology/Head/ Neck Surgery, c Department of Paediatrics, University Hospital
Rotterdam, Sophia Children Hospital, Rotterdam, The Netherlands
Correspondence to: Dr J E Dankert-Roelse, University Hospital Vrije Universiteit, Department of Paediatrics, P O Box 7057, 1007 MB Amsterdam, The Netherlands email: JEDankert{at}azvu.nl
Received 8 September 1999; Returned to authors 11 November 1999; Revised version received 2 February 2000; Accepted for publication 16 June 2000
BACKGROUND
It has been
reported that intranasal corticosteroids can influence bronchial
hyperresponsiveness (BHR) in asthmatic subjects with seasonal rhinitis.
The purpose of the present study was to evaluate the effect of
intranasal fluticasone propionate and beclomethasone dipropionate on
BHR and bronchial calibre (forced expiratory volume in one second,
FEV1) in children and young adults with seasonal rhinitis
and mild asthma during two consecutive grass pollen seasons.
METHODSIn the first
pollen season 25 patients aged 8-28 years were included in a double
blind, placebo controlled study. The active treatment group used
fluticasone aqueous spray 200 µg once daily. In the second pollen
season 72 patients aged 8-28 years participated in a double blind,
placebo controlled study of a similar design to that of the previous
year except that an additional treatment group of patients using
beclomethasone 200 µg twice daily was included. FEV1 was
measured before and after three and six weeks of treatment; BHR to
methacholine (PD20) was measured before and after six weeks
of treatment.
RESULTSIn the first
season the mean (SD) logPD20 of the patients decreased
significantly both in the fluticasone group (from 2.43 (0.8) µg to
1.86 (0.85) µg) and in the placebo group (from 2.41 (0.42) µg to
1.87 (0.78) µg) without any intergroup difference in the change in
logPD20. In the second pollen season the mean logPD20 in the fluticasone, beclomethasone, and placebo
groups did not change significantly.
CONCLUSIONSIntranasal
steroids did not influence BHR during two grass pollen seasons in
children and young adults with seasonal rhinitis and mild asthma.
Keywords: bronchial hyperresponsiveness; corticosteroids; allergic rhinitis; asthma
© 2000 by Thorax
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