Intranasal Corticosteroids and Rhinosinusitis

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary focus of the study regarding intranasal corticosteroids?

The study focuses on how intranasal corticosteroids reduce acute rhinosinusitis in children with allergic rhinitis.

What age group of children was the study conducted on?

The study was conducted on children aged 2 to 18 years.

How were the acute rhinosinusitis cases matched to controls in the study?

Cases were matched to controls based on age, sex, and comorbidities.

What period does the study's cohort cover for patients treated with allergic rhinitis medications?

The cohort covers patients treated between 2002 and 2018. Signup and view all the answers

What were the main types of medications evaluated in the study for their effect on acute rhinosinusitis?

The main medications evaluated were intranasal corticosteroids, second-generation antihistamines, and intranasal antihistamines. Signup and view all the answers

What type of study design was utilized in this research?

The study utilized a nested case-control study design. Signup and view all the answers

What is a significant reason for the increased incidence of acute rhinosinusitis in children with allergic rhinitis?

Children with allergic rhinitis have more acute rhinosinusitis due to inflammation and congestion in the nasal passages. Signup and view all the answers

Which health database was used for conducting the study?

The study used the National Health Research Institutes Database of Taiwan. Signup and view all the answers

What risk does current use of SGH and/or INCS pose compared to remote users of AR drugs?

Current users have a higher risk of acute rhinosinusitis than remote users of AR drugs. Signup and view all the answers

How does the risk of acute rhinosinusitis compare between current users of INCS and recent users of AR drugs?

No difference in risk was found between current users of INCS and recent users of AR drugs. Signup and view all the answers

What effect does the combination treatment of INCS with SGH have on the risk of acute rhinosinusitis?

Current users of INCS with and without SGH have a lower risk than current users of SGH alone. Signup and view all the answers

What is the recommended treatment approach for patients with allergic rhinitis to reduce acute rhinosinusitis risk?

Adequate INCS treatment is important to reduce the incidence of acute rhinosinusitis. Signup and view all the answers

What is the prevalence of allergic rhinitis among children in Taiwan?

Approximately 30% of children in Taiwan are affected by allergic rhinitis. Signup and view all the answers

What does the NHIRD represent in the context of Taiwanese healthcare?

The NHIRD contains details of beneficiaries registered in Taiwan’s National Health Insurance program. Signup and view all the answers

What percentage of Taiwan's population is included in the National Health Insurance program?

Up to 99.8% of the population of Taiwan is included in this program. Signup and view all the answers

How did the authors Chia-ling Lin and Kuo-Huang Lee contribute to the research?

They contributed equally to this work. Signup and view all the answers

What diseases are mentioned as being associated with allergic rhinitis (AR)?

Rhinosinusitis and otitis media. Signup and view all the answers

What is the believed main contributor to the pathogenesis of acute sinusitis?

Viral cold. Signup and view all the answers

What time period did the study utilize for patient data collection?

2002 to 2016. Signup and view all the answers

What information does the NHIRD include regarding patient health records?

Registry of beneficiaries, clinical records, hospitalizations, diagnostic codes, and prescription records. Signup and view all the answers

How do levels of ICAM-1 in patients with grass pollen-induced AR compare to healthy controls?

They are higher in patients with AR. Signup and view all the answers

What classification system do the diagnostic codes in the NHIRD follow?

International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM). Signup and view all the answers

What is a significant risk factor for acute rhinosinusitis identified in the content?

Upper respiratory tract infections (URTIs) and allergic inflammation. Signup and view all the answers

What statistical methods were used to compare the acute rhinosinusitis group to controls?

The Student's t-test was used for continuous parametric data and the chi-square test for categorical data. Signup and view all the answers

How were controls selected for the study on acute rhinosinusitis?

Controls were selected from patients without acute rhinosinusitis and matched to cases based on the AR date (±180 days). Signup and view all the answers

Who endorsed the study mentioned in the content?

The Institutional Review Board of Chia-Yi Christian Hospital in Taiwan. Signup and view all the answers

What is the significance of the study reference date?

The study reference date marks either the diagnosis of acute rhinosinusitis for cases or a follow-up date for controls without the condition. Signup and view all the answers

Which risk factors for acute rhinosinusitis were assessed in the study?

The risk factors evaluated included age, sex, asthma, atopic dermatitis, and GERD. Signup and view all the answers

What software was used to conduct the statistical analyses in the study?

Statistical analyses were conducted using SAS 9.4 for Windows. Signup and view all the answers

What role do antihistamines play in the treatment of acute rhinosinusitis (AR) symptoms in children?

Antihistamines have improved the control of some sinusitis symptoms in patients with acute rhinosinusitis. Signup and view all the answers

Describe how intranasal corticosteroids (INCS) may impact acute rhinosinusitis in patients with asthma.

INCS may provide a small therapeutic advantage in resolving or improving acute rhinosinusitis symptoms. Signup and view all the answers

What findings were reported regarding the relationship between AR medications and the incidence of acute rhinosinusitis?

The study aimed to investigate whether AR treatment with INCS, SGH, and/or INH could reduce the incidence of acute rhinosinusitis in children. Signup and view all the answers

What is the significance of the designated ATC codes in the study?

The ATC codes classify the various medications such as INCS, INHs, and SGHs used in treating allergic rhinitis. Signup and view all the answers

What criteria were used to select patients for the study on acute rhinosinusitis and allergic rhinitis (AR)?

Patients diagnosed with AR more than twice within 90 days and who had taken AR medications were included. Signup and view all the answers

Why were patients diagnosed with AR from 2000 to 2001 excluded from the study?

Patients diagnosed during that period were excluded to maintain a more focused and relevant study cohort. Signup and view all the answers

How did previous studies establish the ineffectiveness of antibiotics in treating acute rhinosinusitis symptoms in children?

A previous study indicated that antibiotic therapy alone cannot resolve acute rhinosinusitis symptoms in children. Signup and view all the answers

What is the primary goal of the study involving AR medications and acute rhinosinusitis?

The primary goal is to investigate whether treatments with INCS, SGH, and/or INH can reduce acute rhinosinusitis incidence in children with AR. Signup and view all the answers

Study Notes

Background

Allergic rhinitis (AR) affects approximately 30% of children in Taiwan.
Children with AR have a significantly higher incidence of acute rhinosinusitis compared to those without AR.
Viral infections contribute to acute sinusitis by obstructing sinus ventilation and impairing mucociliary clearance.

Study Objective

Investigate the impact of intranasal corticosteroids (INCS), second-generation antihistamines (SGH), and intranasal antihistamines (INH) on the occurrence of acute rhinosinusitis in children aged 2-18 years with AR.

Methods

Utilized Taiwan's National Health Research Institutes Database from 2005, focusing on patients diagnosed with AR between 2002 and 2018.
Conducted a nested case-control study comparing current medication users to remote and recent users of AR treatments.
Key terms include INCS (e.g., beclometasone, fluticasone), SGH (e.g., cetirizine), and INH (e.g., azelastine).

Findings

Current users of SGH and/or INCS had a greater risk of acute rhinosinusitis than remote users of AR medications.
No significant risk difference for acute rhinosinusitis between current users of INCS and recent users of AR drugs was observed.
Current users of INCS—either alone or with SGH—demonstrated a lower risk of acute rhinosinusitis compared to those using SGH alone.

Conclusion

Adequate treatment with INCS, whether alone or in conjunction with SGH, reduces the incidence of acute rhinosinusitis in children with AR.
Highlights the importance of effective AR management strategies to prevent related complications like rhinosinusitis.

Statistical Analysis

The study included a matched control group based on age, sex, and comorbidities.
Employed conditional logistic regression to evaluate risk factors for acute rhinosinusitis.

Key Statistics

Cohort comprised 172,200 children diagnosed with AR over the study period.
Asthma and atopic dermatitis were common comorbidities, with prevalence rates around 20.6% and 6.6%, respectively.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This study investigates the effects of intranasal corticosteroids on acute rhinosinusitis in children suffering from allergic rhinitis. Through a nested case-control approach, the research aims to establish a link between treatment and health outcomes in pediatric patients. Discover the implications of this study for allergy management in children.