Objective: To study the effect of allergic rhinitis (AR) management using inhaled intranasal corticosteroid on the outcome of uncontrolled asthma.
Methods: A prospective controlled study. All patients presented with uncontrolled asthma (FEV1 less than 80% with daily rescue medications and more than one urgent care visit/year, and on a high dose of inhaled oral corticosteroid > 880 μg fluticasone/day) with a co morbidity of AR that not received any local nasal corticosteroid treatment within the last 6 months were included in this study. They were subjected to history taking, full chest and ENT examination, skin prick test and measurement of peripheral blood eosinophils and serum total IgE. Baseline spirometry was done for all patients. They received a combined therapy of intranasal corticosteroid (100 μg mometasone) and inhaled oral corticosteroid (500 μg fluticasone) for 3 months. Then reevaluation of pulmonary functions and clinical assessment of nasal allergy control were done.
Results: Forty one patients had combined AR and bronchial asthma and received combined therapy. Thirty three patients showed significant improvement in lung function (FEV1 more than 80%) and maintained a moderate dose of inhaled corticosteroid without rescue medications (p value < 0.01).
Conclusion: AR is an important risk factor of uncontrolled asthma. Concurrent management of AR significantly improves the uncontrolled asthma and significantly reduces the dose of inhaled oral corticosteroid.