Dose-related effect of intranasal corticosteroids on treatment outcome of persistent allergic rhinitis.

Abstract

To evaluate the efficacy of the self-adjustable dosing regimen and explore potential dose-response relationships of intranasal corticosteroids in persistent allergic rhinitis. Prospective cohort study. Sixty-nine persistent allergic rhinitis patients were treated with 220 mcg of intranasal triamcinolone acetonide for 28 days. Patients with mild, intermittent symptoms were instructed to use the medication only after symptoms occurred once a day. Patients with symptoms that lasted more than 1 day and/or interrupted daily activities/sleep were instructed to continue the morning daily dose until they were symptom-free for 24 hours before stopping usage. All nasal symptom scores and peak expiratory flow index (PEFI) showed statistically significant improvements after treatment. At 28 days after treatment, the number of puffs and weight of steroids used were positively correlated with percentages of improvement in total symptoms score (TSS) and PEFI (rho = 0.529, r = 0.571 and rho = 0.350, r = 0.509 respectively). When at least 1400 mcg or 44 puffs were used, 60% TSS and 10% PEFI improvement were achieved. A self-adjustable dosing approach proved to be an efficacious approach to controlling allergic rhinitis.