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The impact of intranasal corticosteroids on lung function in children with allergic rhinitis
Author(s) -
Kessel Aharon
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22912
Subject(s) - medicine , spirometry , lung function , nasal administration , asthma , antihistamine , allergy , gastroenterology , pulmonary function testing , regimen , lung , corticosteroid , anesthesia , immunology
Summary Background Subjects with allergic rhinitis (AR) suffer from impaired lung function, especially decreased FEF 25–75% . The purpose of this study was to examine lung function and the long‐term response to INCS in AR patients with impaired lung function, and to characterize the phenotype of these children. Methods Two hundred two children with AR underwent an allergy evaluation including a skin prick test and spirometry. Children with impaired lung function were treated with daily nasal corticosteroids spray (INCS) and antihistamine as needed. Results Fifty‐three children out of 202 (26.3%) had impaired lung function: 34 of them (64.2%) had FEF 25–75% values under 80% of predicted and normal FEV 1 values, and 19 individuals (35.8%), had both FEF 25–75% and FEV 1 values below 80% of predicted. A positive correlation between FEV 1 and FEF 25–75% values (r = 0.369, P = 0.007) and a reverse correlation between duration of nasal symptoms and FEF 25–75% values (r = −0.364, P = 0.012) were found. Post‐ronchodilation FEV 1 levels increased from 81.9 ± 8.0 to 87.7 ± 10.4 ( P < 0.0001). Thirty‐five of the 53 children complied with a continuous INCS treatment regimen over a period of 3–12 months, demonstrated increased FEF 25–75% (84.4 ± 13.6 vs. 70.1 ± 7.1, P < 0.001) and FEV 1 (92.3 ± 10.9 vs. 84.4 ± 7.8, P < 0.0001) after INCS treatment. However, FEF 25–75% values were still significantly lower compared to the group of AR children with normal lung function (84.4 ± 13.6 vs. 95.7 ± 8.8, P < 0.0001). Conclusions INCS improve FEF 25–75% above 80% of predicted values in 2/3 of children with abnormal lung function. However, this improvement does not reach levels of AR children with normal lung function. Pediatr Pulmonol. 2014; 49:932–937. © 2013 Wiley Periodicals, Inc.