Intranasal steroids help allergic conjunctivitis too

Intranasal corticosteroids (INSs) are a mainstay of treatment of allergic rhinitis (AR) nasal symptoms. The INS mometasone furoate nasal spray (MFNS) has well-documented efficacy and safety for the treatment and prophylaxis of nasal symptoms of seasonal AR (SAR) and for the treatment of nasal symptoms of perennial AR (PAR).

Increasing interest has focused on whether INSs may have beneficial effects on the ocular symptoms frequently associated with AR. Steroid nose sprays improve eye symptoms of AR/AC -  mechanism is unknown, but it might relate to naso-ocular reflex (http://goo.gl/VVt8k).



Treatment Options for Allergic Rhinitis (click to enlarge the image).

This meta-analysis included 10 randomized, placebo-controlled trials (3,000 patients) of the efficacy of MFNS 200 mcg daily in relieving ocular allergy symptoms, including itching/burning, redness, and tearing/watering in both SAR and PAR.

Treatment effect was significant for all three individual ocular symptoms in the SAR studies and in the PAR studies.

There is a growing body of literature supporting the positive class effect of INSs on ocular symptoms associated with SAR and PAR.

References:

Bielory L, Chun Y, Bielory BP, Canonica GW. Impact of mometasone furoate nasal spray on individual ocular symptoms of allergic rhinitis: a meta-analysis. Allergy 2011; DOI: 10.1111/j.1398-9995.2010.02543.x.

Intranasal corticosteroids had a positive impact on the eye symptoms of allergic rhinitis (review of 32 trials) http://goo.gl/EAmg1

Vernal Keratoconjunctivitis - NEJM images, 2012.

NEJM - Image Challenge http://buff.ly/1nts5dD

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