Allergic rhinitis 病患有 ocular symptoms,可先用intranasal steroid單方
Intranasal Steroids for Ocular Symptoms in Allergic Rhinitis
In a randomized trial, intranasal steroids relieved both nasal and ocular symptoms.
Because intranasal steroids are the most effective medications for allergic rhinitis symptoms (especially congestion), guidelines recommend them as first-line agents for moderate-to-severe disease. As many as 85% of patients with seasonal allergic rhinitis also have ocular symptoms. For these patients, many clinicians prescribe oral antihistamines or ocular products rather than (or in addition to) intranasal steroids.
In an industry-sponsored randomized trial, 429 patients with seasonal allergic rhinitis received once-daily mometasone furoate nasal spray (200 µg) or placebo spray for 15 days. Compared with the placebo group, the mometasone group exhibited statistically and clinically significant improvement in both nasal and ocular symptoms.
Comment: Based on this and previous studies, intranasal steroids are superior to oral antihistamines for alleviating nasal symptoms and are equal for relieving ocular symptoms. The mechanism is unclear but could involve a naso-ocular reflex pathway and appears to be a class effect. Adding an oral antihistamine to an intranasal steroid does not consistently confer greater benefits. For patients with moderate-to-severe seasonal allergic rhinitis with ocular symptoms, intranasal steroids are appropriate as monotherapy. If ocular symptoms are not controlled, addition of an ocular antihistamine or mast cell stabilizer is warranted. With respect to cataracts and glaucoma, safety data for intranasal steroids have been consistently reassuring.
— David J. Amrol, MD
對眼睛症狀來說，intranasal steroid和oral antihistamine一樣
對鼻子症狀來說，intranasal steroid 比 oral antihistamine好
所以可先用intranasal steroid單方，不行再加antihistamine
In a randomized trial, intranasal steroids relieved both nasal and ocular symptoms.
Because intranasal steroids are the most effective medications for allergic rhinitis symptoms (especially congestion), guidelines recommend them as first-line agents for moderate-to-severe disease. As many as 85% of patients with seasonal allergic rhinitis also have ocular symptoms. For these patients, many clinicians prescribe oral antihistamines or ocular products rather than (or in addition to) intranasal steroids.
In an industry-sponsored randomized trial, 429 patients with seasonal allergic rhinitis received once-daily mometasone furoate nasal spray (200 µg) or placebo spray for 15 days. Compared with the placebo group, the mometasone group exhibited statistically and clinically significant improvement in both nasal and ocular symptoms.
Comment: Based on this and previous studies, intranasal steroids are superior to oral antihistamines for alleviating nasal symptoms and are equal for relieving ocular symptoms. The mechanism is unclear but could involve a naso-ocular reflex pathway and appears to be a class effect. Adding an oral antihistamine to an intranasal steroid does not consistently confer greater benefits. For patients with moderate-to-severe seasonal allergic rhinitis with ocular symptoms, intranasal steroids are appropriate as monotherapy. If ocular symptoms are not controlled, addition of an ocular antihistamine or mast cell stabilizer is warranted. With respect to cataracts and glaucoma, safety data for intranasal steroids have been consistently reassuring.
— David J. Amrol, MD
對眼睛症狀來說，intranasal steroid和oral antihistamine一樣
對鼻子症狀來說，intranasal steroid 比 oral antihistamine好
所以可先用intranasal steroid單方，不行再加antihistamine
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