Intranasal Corticosteroid Therapy: Systematic Review and Meta‐analysis of Reported Safety and Adverse Effects in Adults
| العنوان: | Intranasal Corticosteroid Therapy: Systematic Review and Meta‐analysis of Reported Safety and Adverse Effects in Adults |
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| المؤلفون: | Daniel H. Kim, Devyani Lal, Lisa A. Marks, Angela M. Donaldson, Garret Choby |
| المصدر: | Otolaryngology–Head and Neck Surgery. 163:1097-1108 |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Pediatrics, medicine.medical_specialty, Side effect, medicine.drug_class, medicine.medical_treatment, Iatrogenic Disease, 03 medical and health sciences, 0302 clinical medicine, Adrenal Cortex Hormones, medicine, Humans, 030223 otorhinolaryngology, Adverse effect, Administration, Intranasal, United States Food and Drug Administration, business.industry, Nasal Sprays, United States, Safety profile, 030228 respiratory system, Otorhinolaryngology, Corticosteroid therapy, Meta-analysis, Corticosteroid, Surgery, Nasal administration, business, Topical steroid |
| الوصف: | To address concerns related to the safety profile of both Food and Drug Administration (FDA)-approved and non-FDA-approved intranasal corticosteroid (INCS) use in the adult population.Systematic review of MEDLINE, PubMed, and EMBASE databases using a comprehensive search strategy including all INCS formulations and adverse events. The study design was developed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additional sources were identified from study references of relevant articles.A structured literature search was conducted. Each study was graded for level of evidence using the Oxford Centre for Evidence-Based Medicine. Extracted data included population size, study design, drug (dosage, route, and frequency), presence of hypothalamus pituitary axis suppression, ocular symptoms, and treatment-related adverse events.A total of 60 studies met inclusion criteria. The studies included use of INCS as metered nasal sprays, drops, injections, aerosols, and irrigations. There were no persistent abnormalities in cortisol level or intraocular pressure change. Meta-analysis of epistaxis showed a significantly increased risk in the FDA-approved treatment group in comparison with control (risk ratio 1.56; 95% confidence interval, 1.13-2.14;Overall, it appears that the use of both FDA and published non-FDA application of INCS are safe in the adult population. Meta-analysis demonstrated an increased risk of epistaxis in patients using INCS compared with placebo. Otherwise, there was no significant difference between in adults in the treatment group and placebo group. As an important caveat, the interpretation of safety of nonstandard INCS is restricted to delivery methods and dosages published in the literature. |
| تدمد: | 1097-6817 0194-5998 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9db8470e7fcaefcf9482f3a2bb892010Test https://doi.org/10.1177/0194599820931455Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....9db8470e7fcaefcf9482f3a2bb892010 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10976817 01945998 |
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