The impact of intranasal corticosteroids on lung function in children with allergic rhinitis

Authors

  • Aharon Kessel MD

    Corresponding author
    1. Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Technion Faculty of Medicine, Haifa, Israel
    • Correspondence to: Kessel Aharon, MD, Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Haifa 31048, Israel. E-mail: aharon.kessel@b-zion.org.il

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  • Conflict of interest: None.

Summary

Background

Subjects with allergic rhinitis (AR) suffer from impaired lung function, especially decreased FEF25–75%. 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 FEF25–75% values under 80% of predicted and normal FEV1 values, and 19 individuals (35.8%), had both FEF25–75% and FEV1 values below 80% of predicted. A positive correlation between FEV1 and FEF25–75% values (r = 0.369, P = 0.007) and a reverse correlation between duration of nasal symptoms and FEF25–75% values (r = −0.364, P = 0.012) were found. Post-ronchodilation FEV1 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 FEF25–75% (84.4 ± 13.6 vs. 70.1 ± 7.1, P < 0.001) and FEV1 (92.3 ± 10.9 vs. 84.4 ± 7.8, P < 0.0001) after INCS treatment. However, FEF25–75% 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 FEF25–75% 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.

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