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Topical glucocorticosteroids in rhinitis: clinical aspects
Niels Mygind1, Morgan Andersson
1Department of Medicine, Vejle Hospital, Vejle, Denmark, and Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Lund, Sweden. niels.mygind@dadlnet.dk
Acta Oto-Laryngologica
|August 23, 2006
Summary
Nasal glucocorticosteroids are a significant advancement in rhinitis treatment, offering effective symptom relief for allergic rhinitis and nasal polyps. These topical steroids demonstrate minimal side effects, establishing them as a preferred first-line therapy.
Area of Science:
- Otorhinolaryngology
- Allergology
- Pharmacology
Background:
- Nasal glucocorticosteroids represent a major therapeutic advance in rhinitis management.
- The nasal mucosa's accessibility facilitates research into glucocorticosteroid mechanisms.
- Despite extensive use, the precise mechanisms underlying their clinical efficacy remain incompletely understood.
Purpose of the Study:
- To review the efficacy and safety of intranasal glucocorticosteroids.
- To delineate the conditions responsive to topical glucocorticosteroids based on inflammatory cell profiles.
Main Methods:
- Review of 30 years of clinical experience and controlled studies.
- Analysis of treatment effectiveness in relation to inflammatory cell types (eosinophils vs. neutrophils).
Main Results:
- Topical glucocorticosteroids are highly effective for eosinophil-driven inflammation (allergic rhinitis, nasal polyposis).
- They are less effective in neutrophil-driven inflammation (common cold, infectious rhinosinusitis).
- Extensive data show high efficacy with few benign side effects.
Conclusions:
- Intranasal glucocorticosteroids are a safe and effective first-line treatment.
- Recommended for allergic rhinitis, non-allergic non-infectious rhinitis, and nasal polyps.