Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London, UK.
Expert Rev Pharmacoecon Outcomes Res. 2010 Feb;10(1):87-90. doi: 10.1586/erp.09.69.
Intranasal corticosteroids are the most effective treatment for allergic rhinitis based on meta-analyses of clinical trials; however, the population in such trials is restricted and may not be representative of patients who are later treated with the medication. The effectiveness of intranasal steroids in the real world has not been assessed.
We asked patients returning to a rhinitis clinic having been treated with intranasal corticosteroids for 3 months to fill in an anonymous questionnaire about their use of this treatment, its effectiveness and any adverse events.
A total of 126 out of 134 patients completed the questionnaire. At least 119 of these had used the intranasal steroid spray; 79% found the sprays helpful, 40% found nasal blockage was reduced and 24% noted reduction of all symptoms. A total of 20% experienced no benefit, 21% noted minor adverse events - the most common being epistaxis in 9%.
The real world effectiveness and adverse event profile of intranasal steroid sprays is similar in clinical practice to that seen in trials. The number needed to treat to obtain symptomatic benefit is 1.26 and to reduce all symptoms is 4. The number needed to harm is 11. Intranasal steroids are an effective and safe first line treatment for rhinitis.
基于临床试验的荟萃分析，鼻内皮质类固醇是治疗过敏性鼻炎最有效的方法；然而，此类试验的人群受到限制，可能无法代表随后接受该药物治疗的患者。鼻内类固醇在真实世界中的疗效尚未得到评估。
我们要求在鼻炎诊所接受鼻内皮质类固醇治疗 3 个月后返回的患者填写一份匿名问卷，了解他们对这种治疗方法的使用情况、疗效以及任何不良反应。
共有 134 名患者中的 126 名完成了问卷。其中至少有 119 名患者使用了鼻内类固醇喷雾剂；79%的患者认为喷雾剂有帮助，40%的患者认为鼻塞减轻，24%的患者注意到所有症状减轻。总的来说，20%的患者没有受益，21%的患者注意到轻微的不良反应——最常见的是鼻出血 9%。
鼻内类固醇喷雾剂在临床实践中的实际疗效和不良反应与试验中观察到的相似。获得症状缓解的治疗需要数为 1.26，缓解所有症状的治疗需要数为 4。产生不良事件的需要数为 11。鼻内类固醇是治疗鼻炎的有效且安全的一线治疗药物。
