The use of rhinitis medications in children receiving initial controller therapy for asthma

ABSTRACT

Background: Due to common features of asthma and allergic rhinitis, a single therapeutic approach to treating both of these conditions has been proposed.

Objective: To compare and contrast the use of rhinitis medications in a group of children initiating various controller therapies for asthma.

Methods: A retrospective, observational study using an integrated managed care database of children aged 4–17 years with an initial medical claim for asthma and an initial pharmacy claim for fluticasone propionate (FP) and salmeterol in a single inhaler (FSC), FP alone, montelukast (MON), or combination FP + MON. Outcomes included the percentage of children initiating controller asthma therapy with prescriptions for non-sedating antihistamine (NSA) and intranasal corticosteroids (INCS) and the mean number of prescriptions for NSA and INCS.

Results: A total of 5247 children were included. The percentage of children who filled prescriptions for NSA or INCS and the mean number of prescriptions dispensed was similar among children treated with FSC, FP, MON, and FP + MON. There were no significant differences in the relative risk of dispensing either a NSA or INCS across cohorts. Observational studies are limited by their use of administrative data and lack of access to patient records.

Conclusions: Children started on common asthma controller therapy are frequent users of rhinitis medications. The quantity and frequency of these medications is not different between dispensed asthma regimens.

Key words: :

• Allergic rhinitis
• Asthma co-morbidities
• Fluticasone
• Intranasal corticosteroids
• Leukotriene receptor antagonists
• Montelukast
• Pediatric asthma