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Registry on assessing the quality of life improvement with triamcinolone in the treatment of moderate-to-severe persistent allergic rhinitis in egyptian patients

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Abstract

Background

Allergic rhinitis is a common disorder that can significantly impact the quality of life of patient. It is strongly linked to asthma and conjunctivitis. The classic symptoms of the disorder are nasal congestion and itching, rhinorrhea, and sneezing. Currently, steroids have played a role in the management of allergic rhinitis. The aim of the study was to assess the efficacy and safety of triamcinolone in the treatment of allergic rhinitis in Egypt.

Patients and methods

A total of 308 Egyptian patients who were suffering from moderate-to-severe allergic rhinitis and were prescribed triamcinolone were enrolled. The improvement in the quality of life of patients receiving triamcinolone after 4 weeks of treatment was assessed using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). All adverse events were recorded during the study duration.

Results

The RQLQ showed a significant improvement in the quality of life of patients after using triamcinolone. The mean RQLQ score before triamcinolone administration was 2.99±1.015 versus 0.68±0.706 after 4 weeks of treatment (P<0.001), with a mean percent reduction of −76.78±23.62%. The individual domain scores of the RQLQ after 4 weeks of treatment showed a significant improvement in the level of all domains. No adverse events were reported and the drug showed a high tolerability profile.

Conclusion

Triamcinolone is considered an efficient and safe drug in the management of allergic rhinitis. It has a positive impact on the quality of life of patients with moderate-to-severe persistent allergic rhinitis under conditions of daily practice in patients receiving triamcinolone after 4 weeks of treatment.

References

  1. 1

    Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001; 108 (Suppl 5):S147–S334. Allergy 2008: 63 (Suppl 86): 8–160 Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update (in collaboration with the World Health Organization, GA2LENFNx01and AllerGenFNx08)

    CAS  Article  Google Scholar 

  2. 2

    Small P, Frenkiel S, Becker A, Boisvert P, Bouchard JMD, Carr S et al. The Canadian Rhinitis Working Group. Rhinitis: a practical and comprehensive approach to assessment and therapy. J Otolaryngol 2007;36 (Suppl 1):S5–S27.

    Article  Google Scholar 

  3. 3

    Gawchik SM, Saccar CL. A risk-benefit assessment of intranasal triamcinolone acetonide in allergic rhinitis. Drug Saf 2000; 23: 309–322.

    CAS  Article  Google Scholar 

  4. 4

    Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol 2008; 122(Suppl):S1–S84.

    Article  Google Scholar 

  5. 5

    Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomized controlled trials. BMJ 1998; 317: 1624–1629.

    CAS  Article  Google Scholar 

  6. 6

    Yanez A, Rodrigo GJ. Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis. Ann Allergy Asthma Immunol 2002; 89: 479–484.

    CAS  Article  Google Scholar 

  7. 7

    Bernstein DI, Levy AL, Hampel FC, Baidoo CA, Cook CK, Philpot EE, Rickard KA Treatment with intranasal fluticasone propionate significantly improves ocular symptoms in patients with seasonal allergic rhinitis. Clin Exp Allergy 2004; 34: 952–957.

    CAS  Article  Google Scholar 

  8. 8

    DeWester J, Philpot EE, Westlund RE, Cook CK, Rickard KA. The efficacy of intranasal fluticasone propionate in the relief of ocular symptoms associated with seasonal allergic rhinitis. Allergy Asthma Proc 2003; 24: 331–337.

    CAS  PubMed  Google Scholar 

  9. 9

    Schenkel E. Features of mometasone furoate nasal spray and its utility in the management of allergic rhinitis. Expert Opin Pharmacother 2003; 4: 1579–1591.

    CAS  Article  Google Scholar 

  10. 10

    Juniper EF, Guyatt GH, Griffith LE, Ferrie PJ. Interpretation of rhinoconjunctivitis quality of life questionnaire data. J Allergy Clin Immunol 1996; 98: 843–845.

    CAS  Article  Google Scholar 

  11. 11

    Bielory L. Differential diagnoses of conjunctivitis for clinical allergist-immunologists. Ann Allergy Asthma Immunol 2007; 98: 105–114. quiz 14–7, 52

    Article  Google Scholar 

  12. 12

    Small P, Kim H. Allergic rhinitis. Allergy Asthma Clin Immunol 2011; 7:(Suppl 1):S3.

    Article  Google Scholar 

  13. 13

    Pauwels R. Mode of action of corticosteroids in asthma and rhinitis. Clin Allergy 1986; 16: 281–288.

    CAS  Article  Google Scholar 

  14. 14

    Pullerits T, Praks L, Ristioja V, Lötvall J. Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol 2002; 109: 949–955.

    CAS  Article  Google Scholar 

  15. 15

    Di Lorenzo G, Pacor ML, Pellitteri ME, Morici G, Di Gregoli A, Lo Bianco C et al. Randomized placebo-controlled trial comparing fluticasone aqueous nasal spray in mono-therapy, fluticasone plus cetirizine, fluticasone plus montelukast and cetirizine plus montelukast for seasonal allergic rhinitis. Clin Exp Allergy 2004; 34:259–267.

    Article  Google Scholar 

  16. 16

    Wilson AM, O’Byrne PM, Parameswaran K. Leukotriene receptor antagonists for allergic rhinitis: a systematic review and meta-analysis. Am J Med 2004; 116: 338–344.

    CAS  Article  Google Scholar 

  17. 17

    Wilson AM, Orr LC, Sims EJ, Dempsey OJ, Lipworth BJ. Antiasthmatic effects of mediator blockade versus topical corticosteroids in allergic rhinitis and asthma. Am J Respir Crit Care Med 2000; 162(Pt 1):1297–1301.

    CAS  Article  Google Scholar 

  18. 18

    Wilson AM, Orr LC, Sims EJ, Lipworth BJ. Effects of monotherapy with intranasal corticosteroid or combined oral histamine and leukotriene receptor antagonists in seasonal allergic rhinitis. Clin Exp Allergy 2001; 31: 61–68.

    CAS  Article  Google Scholar 

  19. 19

    Yáñez A, Rodrigo GJ. Intranasal corticosteroids versus topical H1 receptor antagonists for the treatment of allergic rhinitis: a systematic review with meta-analysis. Ann Allergy Asthma Immunol 2002; 89: 479–484.

    Article  Google Scholar 

  20. 20

    Watson WT, Becker AB, Simons FE. Treatment of allergic rhinitis with intranasal corticosteroids in patients with mild asthma: effect on lower airway responsiveness. J Allergy Clin Immunol 1993; 91(Pt 1):97–101.

    CAS  Article  Google Scholar 

  21. 21

    Condemi J, Schulz R, Lim J. Triamcinolone acetonide aqueous nasal spray versus loratadine in seasonal allergic rhinitis: efficacy and quality of life. Ann Allergy Asthma Immunol 2000; 84: 533–538.

    CAS  Article  Google Scholar 

  22. 22

    Mintz M, Garcia J, Diener P, Liao Y, Dupclay L, Georges G. Triamcinolone acetonide aqueous nasal spray improves nocturnal rhinitis-related quality of life in patients treated in a primary care setting: the Quality of Sleep in Allergic Rhinitis study. Ann Allergy Asthma Immunol 2004; 92: 255–261.

    CAS  Article  Google Scholar 

  23. 23

    Juniper EF, Ståhl E, Doty RL, Simons FE, Allen DB, Howarth PH. Clinical outcomes and adverse effect monitoring in allergic rhinitis. J Allergy Clin Immunol 2005; 115(Suppl 1):S390–S390 S413.

    Article  Google Scholar 

  24. 24

    Wihl JA, Andersson KE, Johansson SA. Systemic effects of two nasally administered glucocorticosteroids. Allergy 1997; 52: 620–626.

    CAS  Article  Google Scholar 

  25. 25

    Howland WCIII, Dockhorn R, Gillman S, Gross GN, Hille D, Simpson B et al. A comparison of effects of triamcinolone acetonide aqueous nasal spray, oral prednisone, and placebo on adrenocortical function in male patients with allergic rhinitis. J Allergy Clin Immunol 1996; 98:32–38.

    CAS  Article  Google Scholar 

  26. 26

    Nayak AS, Ellis MH, Gross GN, Mendelson LM, Schenkel EJ, Lanier BQ et al. The effects of triamcinolone acetonide aqueous nasal spray on adrenocortical function in children with allergic rhinitis. J Allergy Clin Immunol 1998; 101(Pt 1):157–162.

    CAS  Article  Google Scholar 

  27. 27

    Oztürk F, Yücetürk AV, Kurt E, Unlü HH, Ilker SS. Evaluation of intraocular pressure and cataract formation following the long-term use of nasal corticosteroids. Ear Nose Throat J 1998; 77: 846–848. 50–51

    Article  Google Scholar 

  28. 28

    Ernst P, Baltzan M, Deschênes J, Suissa S. Low-dose inhaled and nasal corticosteroid use and the risk of cataracts. Eur Respir J 2006; 27: 1168–1174.

    CAS  Article  Google Scholar 

  29. 29

    Garbe E, LeLorier J, Boivin JF, Suissa S. Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma. JAMA 1997; 277: 722–727.

    CAS  Article  Google Scholar 

  30. 30

    McEvoy CE, Ensrud KE, Bender E, Genant HK, Yu W, Griffith JM, Niewoehner DE Association between corticosteroid use and vertebral fractures in older men with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157(Pt 1):704–709.

    CAS  Article  Google Scholar 

  31. 31

    Leone FT, Fish JE, Szefler SJ, West SL. Systematic review of the evidence regarding potential complications of inhaled corticosteroid use in asthma: collaboration of American College of Chest Physicians, American Academy of Allergy, Asthma, and Immunology, and American College of Allergy, Asthma, and Immunology. Chest 2003; 124: 2329–2340.

    Article  Google Scholar 

  32. 32

    Schoelzel EP, Menzel ML Nasal sprays and perforation of the nasal septum. JAMA 1985; 253: 2046.

    CAS  Article  Google Scholar 

  33. 33

    Cervin A, Andersson M Intranasal steroids and septum perforation − an overlooked complication? A description of the course of events and a discussion of the causes. Rhinology 1998: 36:128–132

    CAS  PubMed  Google Scholar 

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Correspondence to Prof. Mahmoud Elsammaa.

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Elsammaa, M. Registry on assessing the quality of life improvement with triamcinolone in the treatment of moderate-to-severe persistent allergic rhinitis in egyptian patients. Egypt J Otolaryngol 32, 243–247 (2016). https://doi.org/10.4103/1012-5574.192547

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Keywords

  • allergic rhinitis
  • quality-of-life improvement with triamcinolone
  • registry on assessing the quality