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Nasal corticosteroids did not improve asthma control

Treatment of chronic sinonasal disease with nasal corticosteroids for 24 weeks did not improve asthma control in adults and children with asthma in a recent study.

Mario Castro, MD, MPH, Alan A. and Edith L. Wolff Professor of Pulmonary and Critical Care Medicine, Washington University School of Medicine, and colleagues conducted a 24-week random trial of placebo vs. nasal mometasone in 237 adults and 151 children with inadequately controlled asthma at 19 clinical centers from June 2010 to February 2013. Three-hundred nineteen patients completed the study.

Mario Castro

“There was no difference in the Childhood Asthma Control Test score (difference in change with mometasone — change with placebo, –0.38, 95% CI, –2.19 to 1.44; aged 6 to 11years) or Asthma Control Test score (change with mometasone — change with placebo, 0.51; 95% CI, –0.46 to 1.48; aged 12 years and older) in those assigned to mometasone vs. placebo,” the researchers said.

There was no difference in asthma or sinus symptoms in children and adolescents aged 6 to17 years; however, there was a decrease in “episodes of poorly controlled asthma defined by decrease in peak flow.”

The Asthma Symptom Utility Index measured a small difference in asthma symptoms in adults (change with mometasone — change with placebo, 0.06; 95% CI, 0.01 to 0.11) and a change in nasal symptoms (sinus symptom score, change with mometasone — change with placebo, –3.82; 95% CI, –7.19 to –0.45). No difference was observed, however, in asthma quality of life, lung function or episodes of poorly controlled asthma in adults treated with mometasone vs. placebo.

“Long-term treatment with nasal corticosteroids does not improve asthma control in adults or children with inadequately controlled asthma,” the researchers concluded. “Sinonasal disease can be associated with severe asthma, but the efficacy of treating sinonasal disease as a treatment modality for asthma alone is not supported by the current literature.”

Disclosure: See the study for a full list of relevant financial disclosures.