Pharmacology, particle deposition and drug administration techniques of intranasal corticosteroids for treating allergic rhinitis

C Rollema*, E N van Roon, J F M van Boven, P Hagedoorn, T Klemmeier, J W H Kocks, E I Metting, J N G Oude Elberink, T T A Peters, M R M San Giorgi, T W de Vries

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

This review presents an overview of the available literature regarding intranasal corticosteroids (INCs) for the treatment of allergic rhinitis (AR). Various treatment options exist for AR including INCs, antihistamines and leukotriene antagonists. INCs are considered to be the most effective therapy for moderate to severe AR, as they are effective against nasal and ocular symptoms and improve quality of life. Their safety has been widely observed. INCs are effective and safe for short-term use. Local adverse events are observed but generally well-tolerated. The occurrence of (serious) systemic adverse events is unlikely but cannot be ruled out. There is a lack of long-term safety data. INC may cause serious eye complications. The risk of INCs on the hypothalamic-pituitary-adrenal axis, on bone mineral density reduction or osteoporosis and on growth in children should be considered during treatment. Pharmacological characteristics of INCs (e.g. the mode of action and pharmacokinetics) are well known and described. We sought to gain insight into whether specific properties affect the efficacy and safety of INCs, including nasal particle deposition, which the administration technique affects. However, advances are lacking regarding the improved understanding of the effect of particle deposition on efficacy and safety and the effect of the administration technique. This review emphasizes the gaps in knowledge regarding this subject. Advances in research and healthcare are necessary to improve care for patients with AR.

Original languageEnglish
Pages (from-to)1247-1263
Number of pages17
JournalClinical and Experimental Allergy
Volume52
Issue number11
Early online date10-Aug-2022
DOIs
Publication statusPublished - Nov-2022

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