ReviewJournal of asthma and allergy2021
Intranasal Corticosteroids: Topical Potency, Systemic Activity and Therapeutic Index.
Review in Journal of asthma and allergy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Symptomatic Interventions for Allergic Rhinitis Without Comorbid Asthma: A Dose-Stratified Network Meta-analysis.Clinical drug investigation · 2026Pooled it
- European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency.The Journal of clinical endocrinology and metabolism · 2024Guideline
- Soft drugs: design principles and topical applications.Nature reviews. Drug discovery · 2026Review
- Safety, Efficacy, and Mechanism of Action of Budesonide in Rhinitis and Rhinosinusitis: A Systematic Review.World journal of otorhinolaryngology - head and neck surgery · 2026Review
- Corticosteroid Exposure in Chronic Rhinosinusitis and Global Airway Disease: Adrenal and Bone Impact.The Laryngoscope · 2026Article
- Evaluating the efficacy and safety of Stapokibart (CM310) in the treatment of uncontrolled seasonal allergic rhinitis based on real-world research.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- The definition of response and inadequate response to topical corticosteroid treatment in atopic dermatitis and related skin inflammatory diseases: A GAThe World Allergy Organization journal · 2026Article
- Assessment of the Effectiveness of Allergic Rhinitis Medications Using a Target Trial Emulation Approach Based on Mobile Health Data.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2026Article
- Unveiling natural anti-inflammatory compounds for sinusitis treatments by modulating FOXP3, C5aR1, and LIF.Frontiers in immunology · 2026Review
- A retrospective study on the effectiveness and safety of the combination of intranasal corticosteroid and intranasal antihistamine in the management of patients with allergic rhinitis.Frontiers in allergy · 2026Article
- Long-term intranasal corticosteroids vs. antihistamines and bone health in post-menopausal women with allergic rhinitis: a retrospective cohort study.Frontiers in medicine · 2026Article
- Pregnancy Rhinitis: Pathophysiological Mechanisms, Diagnostic Challenges, and Management Strategies-A Narrative Review.Life (Basel, Switzerland) · 2025Review
- Mometasone Furoate-Induced Iatrogenic Cushing's Syndrome and Secondary Adrenal Insufficiency: A Case Report.Case reports in pediatrics · 2025Article
- The Effect of Whitening Creams Usage on the Adrenal Gland .F1000Research · 2025Article
- Unravelling allergic rhinitis: exploring pathophysiology, advances in treatment, and future directions.Frontiers in allergy · 2025Review
- Risks Associated with the Use of Intranasal Corticosteroids: An Analysis of Adverse Reactions Reported to EudraVigilance.Healthcare (Basel, Switzerland) · 2024Article
- Systemic Adverse Events Associated with Locally Administered Corticosteroids.Children (Basel, Switzerland) · 2024Article
- Impact of inhaled and intranasal corticosteroids on glucose metabolism and diabetes mellitus: A mini review.World journal of diabetes · 2023Review
- [The need for an integrated approach to rhinitis and asthma]Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2023Article
- Pharmacology, particle deposition and drug administration techniques of intranasal corticosteroids for treating allergic rhinitis.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Intranasal corticosteroid (INCS) therapy is the preferred treatment option for allergic rhinitis (AR). Although all INCSs for the treatment of AR are considered safe and effective, differences in potency, molecular structure features and physicochemical and pharmacokinetic properties could result in differences in clinical efficacy and safety. Higher glucocorticoid receptor (GR) binding affinity of INCS is associated with higher lipophilicity, nasal tissue retention and topical potency. Higher topical potency is also accompanied by low oral bioavailability and high systemic clearance conferring low systemic exposure, reduced potential for systemic adverse effects and an improved therapeutic index. It has been shown that adverse events related to systemic exposure of INCSs in children are low. Although INCSs mostly produce low systemic effects, use of an INCS with low systemic exposure in patients on multiple corticosteroid (CS) therapies could help reduce the total systemic burden of CS therapy. Despite differences in topical potency, physicochemical and pharmacokinetic properties between INCSs, clinical studies of INCSs in the treatment of AR generally show no clinically important differences between these compounds, and poor correlation between INCS topical potency and clinical response. However, the lack of head-to-head comparisons of INCSs in clinical studies conducted in more severe AR patients should be noted. This narrative review provides an assessment of the therapeutic relevance of topical potency and the physicochemical and pharmacokinetic properties of INCSs and describes for the first time the relationship between topical potency and therapeutic index using pharmacological features of INCSs. It concludes that higher GR binding affinity and topical potency can potentially improve the therapeutic index of an INCS. Therefore, both efficacy and systemic exposure profiles should be considered when comparing INCS regimens in terms of therapeutic equivalence, to aid clinical decision-making and avoid the assumption that all INCS formulations are the same when considering treatment options.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.