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Hay fever and a single intramuscular injection of corticosteroid: a systematic review

Østergaard, M; Østrem, A and Söderström, Margareta LU (2005) In Primary Care Respiratory Journal 14(3). p.124-130
Abstract
Objectives:



In severe hay fever, some patients are strongly affected despite the use of first-line therapy and are therefore treated with an intramuscular injection of systemic corticosteroid (i.m. SCS) in some countries. The aim of this paper was to explore the efficacy and side effects of a single i.m. SCS injection in hay fever in adults.

Data sources:



PubMed, EMBASE, Cochrane Library.

Methods:



Systematic review. Criteria for inclusion: hay fever or seasonal allergic rhinitis, adults, injectable steroids, clinical trials, English language. None of the clinical trials were excluded, since an important aim of the review was to identify any possible side-effects.... (More)
Objectives:



In severe hay fever, some patients are strongly affected despite the use of first-line therapy and are therefore treated with an intramuscular injection of systemic corticosteroid (i.m. SCS) in some countries. The aim of this paper was to explore the efficacy and side effects of a single i.m. SCS injection in hay fever in adults.

Data sources:



PubMed, EMBASE, Cochrane Library.

Methods:



Systematic review. Criteria for inclusion: hay fever or seasonal allergic rhinitis, adults, injectable steroids, clinical trials, English language. None of the clinical trials were excluded, since an important aim of the review was to identify any possible side-effects. Outcome measures: clinical effects, and clinical and physiological side-effects.

Results:



18 clinical trials met the inclusion criteria: nine double-blind RCTs (five placebo-controlled and four comparative RCTs), two single-blinded RCTs, and seven open trials. All studies were conducted before 1988. The efficacy of a single intramuscular injection of SCS was statistically significant in all five placebo-controlled trials and demonstrated considerable clinical benefit, lasting approximately from within the first day to four weeks. In the only two studies comparing i.m. SCS to nasal steroids a superior effect with i.m. SCS was demonstrated. The side-effects were few, both clinically and physiologically, with retained ability to respond to stress with hypothalamic-pituitary-adrenal activation.

Conclusions:



The studies in this review were sound and their findings consistent: i.m. SCS therapy was shown to be efficient and safe for the treatment of hayfever in adults. This review shows no support for any concerns regarding serious tissue atrophy or other serious side-effects, any long-lasting suppression of plasma-cortisol, or any influence on stress reaction, following a single intramuscular injection of SCS. (Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Side effects, Systematic review, Efficacy, Intramuscular corticosteroids, Hay fever
in
Primary Care Respiratory Journal
volume
14
issue
3
pages
124 - 130
publisher
Elsevier
external identifiers
  • scopus:19344362977
ISSN
1475-1534
DOI
10.1016/j.pcrj.2004.08.001
language
English
LU publication?
no
id
5a7a3c9c-c07b-4aa7-8760-883b03576e02 (old id 1134319)
date added to LUP
2008-06-18 09:53:12
date last changed
2017-08-27 04:01:49
@article{5a7a3c9c-c07b-4aa7-8760-883b03576e02,
  abstract     = {Objectives:<br/><br>
<br/><br>
In severe hay fever, some patients are strongly affected despite the use of first-line therapy and are therefore treated with an intramuscular injection of systemic corticosteroid (i.m. SCS) in some countries. The aim of this paper was to explore the efficacy and side effects of a single i.m. SCS injection in hay fever in adults.<br/><br>
Data sources:<br/><br>
<br/><br>
PubMed, EMBASE, Cochrane Library.<br/><br>
Methods:<br/><br>
<br/><br>
Systematic review. Criteria for inclusion: hay fever or seasonal allergic rhinitis, adults, injectable steroids, clinical trials, English language. None of the clinical trials were excluded, since an important aim of the review was to identify any possible side-effects. Outcome measures: clinical effects, and clinical and physiological side-effects.<br/><br>
Results:<br/><br>
<br/><br>
18 clinical trials met the inclusion criteria: nine double-blind RCTs (five placebo-controlled and four comparative RCTs), two single-blinded RCTs, and seven open trials. All studies were conducted before 1988. The efficacy of a single intramuscular injection of SCS was statistically significant in all five placebo-controlled trials and demonstrated considerable clinical benefit, lasting approximately from within the first day to four weeks. In the only two studies comparing i.m. SCS to nasal steroids a superior effect with i.m. SCS was demonstrated. The side-effects were few, both clinically and physiologically, with retained ability to respond to stress with hypothalamic-pituitary-adrenal activation.<br/><br>
Conclusions:<br/><br>
<br/><br>
The studies in this review were sound and their findings consistent: i.m. SCS therapy was shown to be efficient and safe for the treatment of hayfever in adults. This review shows no support for any concerns regarding serious tissue atrophy or other serious side-effects, any long-lasting suppression of plasma-cortisol, or any influence on stress reaction, following a single intramuscular injection of SCS.},
  author       = {Østergaard, M and Østrem, A and Söderström, Margareta},
  issn         = {1475-1534},
  keyword      = {Side effects,Systematic review,Efficacy,Intramuscular corticosteroids,Hay fever},
  language     = {eng},
  number       = {3},
  pages        = {124--130},
  publisher    = {Elsevier},
  series       = {Primary Care Respiratory Journal},
  title        = {Hay fever and a single intramuscular injection of corticosteroid: a systematic review},
  url          = {http://dx.doi.org/10.1016/j.pcrj.2004.08.001},
  volume       = {14},
  year         = {2005},
}