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 influen ce bronchial hyperresponsiveness (BHR) in asthmatic subjects with seasonal rhinitis. The purpose of the present study was to evaluate the effect of in tranasal fluticasone propionate and beclomethasone dipropionate on BHR and bronchial calibre (forced expiratory volume in one second, FEV1) in childre n and young adults with seasonal rhinitis and mild asthma during two consec utive grass pollen seasons. Methods-In the first pollen season 25 patients aged 8-28 years were include d in a double blind, placebo controlled study. The active treatment group u sed fluticasone aqueous spray 200 mu g once daily. In the second pollen sea son 72 patients aged 8-28 years participated in a double blind, placebo con trolled study of a similar design to that of the previous year except that an additional treatment group of patients using beclomethasone 200 mu g twi ce daily was included. FEV1 was measured before and after three and six wee ks of treatment; BHR to methacholine (PD20) was measured before and after s ix weeks of treatment. Results-In the first season the mean (SD) logPD(20) of the patients decreas ed significantly both in the fluticasone group (from 2.43 (0.8) mu g to 1.8 6 (0.85) mu g) and in the placebo group (from 2.41 (0.42) mu g to 1.87 (0.7 8) mu g) without any intergroup difference in the change in logPD(20). In t he second pollen season the mean logPD(20) in the fluticasone, beclomethaso ne, and placebo groups did not change significantly. Conclusions-Intranasal steroids did not influence BHR during two grass poll en seasons in children and young adults with seasonal rhinitis and mild ast hma.