Preview

Meditsinskiy sovet = Medical Council

Advanced search

Inhaled glucocorticosteroids in otorhinolaryngology

https://doi.org/10.21518/2079-701X-2020-1-50-58

Abstract

Currently, there is a wide introduction of inhaled  glucocorticosteroids (InGCS) into otorhinolaryngological practice, which is explained by their local impact and low bioavailability, as well as proven high therapeutic effectiveness in various forms of rhinosinusitis (RS), adenoiditis and allergic rhinitis (AR). The feasibility of using InGCS enshrined in international consensus documents. Thus, this group of drugs is recommended  for use in acute postviral and bacterial  MS, chronic MS, polypous chronic rhinosinusitis, and in the postoperative period when intervening in the nasal cavity and in the paranasal sinuses.

Recently, due to the deterioration of the environmental situation in the world and in connection with the improvement of the diagnosis of sensitization, the number of patients suffering from AR has increased. InGCS are included in the complex of treatment of moderate and severe course of intermittent and persistent AR.

The effectiveness of InGCS in non-allergic eosinophilic rhinitis has been proved. In the complex therapy of adenoids and chronic adenoiditis, InGCS is also used with a high degree of efficiency, which allows such patients to avoid invasive treatment methods, including adenotomy.

Particularly severe course of RS and adenoids is observed in patients with allergies. In this situation, the feasibility of using InGCS has been proven.

One of the most effective and safe drugs in this group is fluticasone propionate (FP) - Flixonase, especially if the patient is sensitized to inhaled allergens. The advantages and possible side effects of FP are described.

The authors cite the results of their own research, which used FP in the complex treatment of children with nasal breathing difficulties caused by adenoids and various forms of AR. As a result of 3 months of treatment and follow-up, 95.2% of patients recovered nasal breathing and no need for surgical removal of adenoids.

The authors consider the feasibility and effectiveness of using inhaled glucocorticosteroids in the treatment of major diseases of the ENT organs, such as various forms of rhinosinusitis (RS), allergic and non-allergic rhinitis, and adenoiditis. It is emphasized that this group of drugs has an evidence base and is included in the main concession documents on otorhinolaryngology. Their advantages, pharmacotherapy and possible side effects are noted. The advantages of the drug fluticasone propionate (Flixonase), the relevance and advantages of its use are highlighted. The paper presents the authors own observations in the treatment of patients with nasal polypous chronic RS with this drug.

About the Authors

T. I. Garashchenko
Research and Clinical Center for Otorhinolaryngology of the Federal Medico-Biological Agency; N.I. Pirogov Russian National Research Medical University
Russian Federation

Tat’yana I. Garashchenko - Dr. of Sci. (Med), professor, academic secretary, Federal State Budgetary Institution “Research and Clinical Center for Otorhinolaryngology of the Federal Medico-Biological Agency“; рrofessor of the Department of Otolaryngology, Federal State Autonomous Educational  Institution of Higher Education “N.I. Pirogov Russian National  Research Medical University“ of the Ministry of Health of the Russian Federation.

30/2, Volokolamskoe Shosse, Moscow, 123182; 1, Ostrovityanova str., Moscow, 117997.



G. D. Tarasova
Research and Clinical Center for Otorhinolaryngology of the Federal Medico-Biological Agency
Russian Federation

Galina D. Tarasova - Dr. of Sci. (Med), senior researcher, Federal State Budgetary Institution “Research and Clinical Center for Otorhinolaryngology of the Federal Medico-Biological Agency“.

30/2, Volokolamskoe Shosse, Moscow, 123182.



References

1. Fokkens WJ., Lund VJ., Mullol J., Bachert C., Alobid I., Baroody F. et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngolo-gists. Rhinology. 2012;50(1):1-12. doi: 10.4193/Rhino50E2.

2. Brozek J.L., Bousquet J., Agache I., Agarwal A., Bachert C., Bosnic S. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines - 2016 revision. J Allergy Clin Immunol. 2016;140(4):950-958. doi: 10.1016/j.jaci.2017.03.050.

3. Orlandi R., Kingdom T.T., Hwang P.H. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis Executive Summary. International Forum of Allergy & Rhinology. 2016,6(S1):S3-S21. doi: 10.1002/alr.21694.

4. Kochetkov P.A., Rakunova E.B. Treatment features of chronic rhinisinusitis in patients with perennial allergic rhinitis. Meditsinskiy sovet = Medical Council. 2018;(8):78-82. (In Russ.) doi: 10.21518/2079-701X-2018-8-78-82.

5. Astafeva N.G., Udovichenko E.N., Gamova I.V., Perfilova I.A. Treatment of non-allergic rhinitis symptoms: the estimation of effectiveness, safety and clinical equivalence of generics, containing propionate of flutikazon. Lechashchiy vrach = Attending physician. 2012;(9):91. (In Russ.) Available at: https://www.lvrach.ru/2012/09/15435540/

6. Lopatin A.S. (ed.), Aref'eva N.A., Vishnyakov V.V., Ivanchenko O.A., Karpishchenko S.A., Kiselev A.B., Kozlov V.S. et al. Chronic rhinosinusitis: pathogenesis, diagnosis and treatment principles: clinical guidelines. Moscow, Prakticheskaya meditsina; 2014. 64 p. (In Russ.) Available at: https://www.osp.ru/netcat_files/userfiles/lvrach/Sinusit-recommendations.pdf.

7. Turovskiy A.B. Chronic sinusitis. New drug therapy options. Poliklinika = Polyclinic. 2013;(2):66-68. (In Russ.) Available at: http://www.poliklin.ru/imagearticle/201302(1)/66-68.pdf.

8. Kryukov A.I., Studyoniy M.E., Artemyev M.E., Chumakov P.L., Rynkov D.A., Gorin D.S. Treatment of patients with rhinosinusitis: conservative and surgical treatment. Meditsinskiy sovet = Medical Council. 2012;(11):92-96. (In Russ.) Available at: https://elibrary.ru/item.asp?id=18751240.

9. Shamkina P.A., Krivopalov A.A., Ryazantsev S.V., Shnayder N.A., Gaydukov S.S., Shardanov Z.N. Epidemiology of chronic rhinosinusitis. Sovremennye problemy nauki i obrazovaniya = Modern problems of science and education. 2019;(3). (In Russ.) Available at: http://science-education.ru/ru/article/view?id=28891.

10. Anand V. K. Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 2004;113(5):3-5. doi: 10.1177/00034894041130s502.

11. Asher M.I., Montefort S., Bjorksten B., Lai Ch. K.W., Strachan D.P, Weiland S.K. et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733-743. doi: 10.1016/S0140-6736(06)69283-0.

12. Katelaris C.H., Lee B.W., Potter PC., Maspero J.F., Cingi C., Lopatin A. et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clin Exp Allergy. 2012;42(2):186-207. doi: 10.1111/j.1365-2222.2011.03891.x.

13. Ryazantsev S.V., Goncharov O.I. Allergic rhinitis. Meditsinskiy sovet = Medical Council. 2018;(20):76-79. (In Russ.) doi: 10.21518/2079-701X-2018-20-76-79.

14. Tarasova G.D. (ed.) Allergic rhinoconjunctivitis in children. Moscow, GEOTAR-Media; 2017; 128 p. (In Russ.) Available at: https://www.rosmedlib.ru/book/ISBN9785970439555.html.

15. Sergeev A.V., Mokronosova M.A. Oral allergy syndrome. Meditsinskaya immunologiya = Medical Immunology (Russia). 2011;13(1):17-28. (In Russ.) doi: 10.15789/1563-0625-2011-1-17-28.

16. Protasov P.G., Tarasova G.D., Mokronosova M.A., Beylina V.B., Kaznacheeva E.I. Exfoliation cytologi-cal analysis in differential diagnosis of ENT diseases. Moscow; 2006; 31 p. (In Russ.) Available at: https://medznate.ru/docs/index-20580.html.

17. Demoly P. Passalacqua G., Pfaar O., Sastre J., Wahn U. Management of the polyallergic patient with allergy immunotherapy; a practice-based approach. Allergy Asthma Clin Immunol. 2016;12:2-5. doi: 10.1186/s13223-015-0109-6.

18. Pelikan Z. Role of nasal allergy in chronic secretory otitis media. Current Allergy and Asthma Reports. 2009;9(2):107-113. doi: 10.1007/s11882-009-0016-3.

19. Garashchenko T.I., Babakina L.A. Flixonase administration in children with allergic rhinitis. In: Actual issues of otorhinolaryngology in children and pharmacotherapy of ENT diseases. Collection of scientific papers. Moscow; 2001, pp. 118-121.

20. Gonzalez C., Macias Fernandez L.A., Butron Sih T.M., Chaverri-Polini J., Melendez-Medina A.M. et al. Pan-American Clinical Practice Guideline for Management of Acute Tonsillitis and Adenoid Hypertrophy. Available at: https://www.researchposters.com/Posters/AAOHNSF/AAO2012/SP450.pdf.

21. Di Lorenzo G., Pacor M.L., Pellitteri M.E., 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(8):1329-1329. doi: 10.1111/j.1365-2222.2004.2075_1.x.

22. Benincasa C., Lloyd R.S. Evaluation of Fluticasone Propionate Aqueous Nasal Spray Taken Alone and in Combination with Cetirizine in the Prophylactic Treatment of Seasonal Allergic Rhinitis. Drug Invest. 1994;8(4):225-233. Available at: https://link. springer.com/article/10.1007/BF03258482.

23. Ratner P, Van Bavel J., Mohar D., Jacobs R.L., Hampel F., Howland W., Karwal R. Efficacy of daily intranasal fluticasone propionate on ocular symptoms associated with seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2015;114(2):141-147. doi: 10.1016/j.anai.2014.11.012.

24. Small M., Piercy J., Demoly P, Marsden H. Burden of illness and quality of life in patients being treated for seasonal allergic rhinitis: a cohort survey. Clin and Translat Allergy. 2013;3. doi: 10.1186/2045-7022-3-33.

25. Baroody F.M., Brown D., Gavanescu L., DeTineo M., Naclerio R.M. Oxymetazoline adds to the effectiveness of fluticasone furoate in the treatment of perennial allergic rhinitis. J Allergy Clin Immunol, 2011;127(4):927-934. doi: 10.1016/j.jaci.2011.01.037.

26. Demirhan H., Aksoy F., Ozturan O., Yildirim Y.S., Veyseller B. Medical treatment of adenoid hypertrophy with “fluticasone propionate nasal drops". International Journal Of Pediatric Otorhinolaryngology. 2010;74(7):773-776. doi: 10.1016/j.ijporl.2010.03.051.

27. Garashchenko T.I., Shimareva E.V, Topical corticosteroid therapy in the treatment of allergic adenoids in children. Materia Medica. 2004;2:42-45. (In Russ.)

28. Collins M.P., Church M.K., Bakhshi K.N., Osborne J. Adenoid histamine and its possible relationship to secretory otitis media. The Journal of Laryngology and Otology. 1985;99(7):685-691. doi: 10.1017/S0022215100097486.

29. Chen C.F., Wu K.G., Hsu M.C., Tang R.B. Prevalence and relationship between allergic diseases and infectious diseases. J Microbiol Immunol Infect. 2001;34(1):57-62. Available at: https/Www.ncbi.nlm.nih.gov/pub-med/11321129.

30. Choi C.H., Poroyko V., Watanabe S., Jiang D., Lane J., deTineo M. et al. Seasonal allergic rhinitis affects sinonasalmicrobiota. Am J RhinologyAllergy. 2014;28(4):281-286. doi: 10.2500/ajra.2014.28.4050.

31. Johnson M. Development of fluticasone propionate and comparison with other inhaled corticosteroids. J Allergy Clin Immunol. 1998;101(4):S434-S439. doi: 10.1016/S0091-6749(98)70155-1.

32. Vavilova V.P., Vayman O.A., Chernyuk O.S., Karaul'nova T.A., Garashchenko T.I. Tactics for children with combined lymphopharyngeal ring pathology and allergies. Detskaya otorino-laringologiya = Children’s otorhinolaryngology. 2011;1:64-68. (In Russ.) doi: 10.15690/vsp.v14i5.1439.

33. Kirdeeva A.I., Kosiakov S.Ya. The characteristics of pathogenesis and therapy of acute rhinosi-nusitis in patients with allergic rhinitis. Consilium Medicum. 2017;19(3):91-94. (In Russ.) Available at: https://elibrary.ru/item.asp?id=29769197.

34. Loesel L.S. Detection of allergic disease in adenoid tissue. Am J Clin Pathol. 1984;81(2):170-175. doi: 10.1093/ajcp/81.2.170.

35. Marseglia G.L., Poddighe D., Caimmi D., Marseglia A.. Caimmi S., Ciprandi G. et al. Role of adenoids and adenoiditis in children with allergy and otitis media. Curr Allergy Asthma Rep. 2009;9(6):460-464. doi: 10.1007/s11882-009-0068-4.

36. Aksoy F., Dogan R., Kocak I., Veyseller B., Ozturan O., Inciret S. Effect of Nasal Corticosteroid on Secretory Immunoglobulin A Measured in Rat Nasal Lavage: Experimental Study. Otolaryngol -Head Neck Surg. 2015;153(2):298-301. doi: 10.1177/0194599815589073.

37. Mokronosova M.A. Effect of nasal fluticasone propionate spray on allergic rhinitis symptoms and nasal secret eosinophilia. Farmateka. 2004;(12):11-12. (In Russ.) Available at: https://pharmateca.ru/ru/archive/article/5536.

38. Boner A.L. Effects of intranasal corticosteroids on the hypothalamic-pituitary-adrenal axis in children. J Allergy Clin Immunol. 2001;108(1):32-39. doi: 10.1067/mai.2001.115564.

39. Allen D.B., Meltzer E.O., Lemanske R.F. Jr.. Philpot E.E., Faris MA., Kral K.M. et al. No Growth Suppression in children treated with the maximum recommended dose of fluticasone propionate aqueous nasal spray for one year. Allergy Asthma Proc. 2002;23(6):407-413. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12528607.

40. Svistushkin VM., Kochetkov PA., Shchennikova E.S., Karpova O.Yu. Role of fluticasone propionate in modern treatment of allergic rhinitis. Consilium Medicum. 2018;20(11):13-16. (In Russ.) Available at: https://elibrary.ru/item.asp?id=36733375.

41. Zitt M., Kosoglou T., Hubbell J. Mometasonefuroate nasal spray: a review o safety and systemic effects. Drug Safety. 2007;30(4):317-326. doi: 10.2165/00002018-200730040-00004.

42. Lund VJ., Flood J., Sykes A.P, Richards D.H. Effect of fluticasone in severe polyposis. Arch Otolaryngol Head Neck Surg. 1998;124(5):513-518. doi: 10.1001/archotol.124.5.513.

43. Yagudin R.K., Vnukova M.A. Fluticasone propionate. 10 years of clinical application in world practice in the treatment of polyposis of the nose. Rinologiya = Rinology. 2005;(2):47-54. (In Russ.) Available at: https://www.sites.google.com/site/entkazan/professional/articles/4-1.

44. Zabolotnyy D.I. Treatment of patients with allergic rhinitis, polyposis rhinosinusitis associated with bronchial asthma. Ukrainskiy pul’monologicheskiy zhurnal = Ukrainian Pulmonology Journal. 2000;(2):43-46. (In Russ.) Available at: http://www.ifp.kiev.ua/doc/journals/upj/00_dop/upj(dop13)2000.htm.

45. Boenko S.K. Intranasal corticosteroids in the treatment of allergic rhinitis and polypous sinusitis. Journal of Ear, Nose and Throat Diseases. 2002;(5):5-6.

46. Lopatin A.S. The role of topical corticosteroid therapy in the treatment of chronic polyposis rhinosinusitis. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology 1999;(2):54-58. (In Russ.) Available at: http://nature.web.ru/db/msg.html?mid=1174800&uri=index.html.

47. Bryson H.M., Faulds D. Intranasal fluticasone propionate. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in allergic rhinitis. Drugs. 1992;43(5):760-775. doi: 10.2165/00003495-199243050-00009.

48. Fowler P.D., Gazis A.G., Page S.R., Jones N.S. A randomized double-blind study to compare the effects of nasal fluticasone and betamethasone on the hypothalamo-pituitary-adrenal axis and bone turnover in patients with nasal polyposis. Clin Otolaryngol. 2002;27(6):489-493. doi: 10.1046/j.1365-2273.2002.00627.x.

49. Umland S.P, Schleimer R.P, Johnston S.L. Review of the molecular and cellular mechanisms of action of glucocorticoids for use in asthma. Pulm Pharmacol Ther. 2002;15(1):35-50. doi: 10.1006/pupt.2001.0312.

50. Roumestan C., Henriquet C., Bousquet J., Mathieu M. Fluticasone propionate and mometasone furoate have equivalent transcriptional potencies. Clin Exp Allergy. 2003;33(7):895-901. doi: 10.1046/j.1365-2222.2003.01709.x.

51. Chong L.Y., Head K., Hopkins C., Philpott C., Burton MJ., Schilder A.G.M. Different types of intranasal steroids for chronic rhinosinusitis. Cochrane Systematic Review - Intervention. 2016. doi: 10.1002/14651858.CD011993.pub2.


Review

For citations:


Garashchenko TI, Tarasova GD. Inhaled glucocorticosteroids in otorhinolaryngology. Meditsinskiy sovet = Medical Council. 2020;(1):50-58. (In Russ.) https://doi.org/10.21518/2079-701X-2020-1-50-58

Views: 2914


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)