Corticosteroids for Allergic Rhinitis

Abstract

Allergic rhinitis (AR) is one of the most common allergic diseases. Globally, it is estimated to affect more than 500 million people. The burden of allergic rhinitis is overwhelming due to costs caused by sickness absence, medication, and suboptimal performance by the affected population. AR is characterized by a type I allergic reaction in the epithelium of the nose including both an acute phase reaction and a late phase reaction. The allergic reaction causes exudation, itching, sneezing, and later blocking of the nose. Very often, the nasal symptoms are accompanied by eye symptoms (itching and hyperaemia) and oral allergy syndrome. The treatment of AR include patient education, allergen avoidance, pharmacotherapy, and in a selection of patients, allergen immunotherapy (AIT). The cornerstone of pharmacotherapy is the intranasal corticosteroids (INS). Intranasal application of corticosteroids is regarded as a very efficient treatment—treating not only the acute phase symptoms but also the late phase reaction. The treatment is safe and causes only a few well-known side effects. The aim of this review is to provide an overview of all aspects of corticosteroid treatment including mode of application (per oral, intranasal, intramuscular), way of action, potency, bioavailability, side effects, and aspects regarding the pediatric population.