Influence of intranasal steroids during the grass pollen season on bronchial responsiveness in children and young adults with asthma and hay fever

Background - It has been reported that intranasal corticosteroids can influence bronchial hyperresponsiveness (BHR) in asthmatic subjects with seasonal rhinitis. The purpose of the present study was to evaluate the effect of intranasal fluticasone propionate and beclomethasone dipropionate on BHR and bronchial calibre (forced expiratory volume in one second, FEV1) in children and young adults with seasonal rhinitis and mild asthma during two consecutive grass pollen seasons. Methods - In the first pollen season 25 patients aged 8-28 years were included in a double blind, placebo controlled study. The active treatment group used fluticasone aqueous spray 200 μg once daily. In the second pollen season 72 patients aged 8-28 years participated in a double blind, placebo controlled study of a similar design to that of the previous year except that an additional treatment group of patients using beclomethasone 200 μg twice daily was included. FEV1 was measured before and after three and six weeks of treatment; BHR to methacholine (PD20) was measured before and after six weeks of treatment. Results - In the first season the mean (SD) logPD20 of the patients decreased significantly both in the fluticasone group (from 2.43 (0.8) μg to 1.86 (0.85) μg) and in the placebo group (from 2.41 (0.42) μg to 1.87 (0.78) μg) without any intergroup difference in the change in logPD20. In the second pollen season the mean logPD20 in the fluticasone, beclomethasone, and placebo groups did not change significantly. Conclusions - Intranasal steroids did not influence BHR during two grass pollen seasons in children and young adults with seasonal rhinitis and mild asthma.

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