Allergic Rhinitis in Children is Often Overlooked and Undertreated

Expert Panel Recommends Improved Detection and Treatment to Reduce Effects on Children's Health and Well-Being

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"All too frequently, allergic rhinitis in children goes unrecognized, which can lead to suboptimal control of the disease," said David Skoner, Chief of Allergy and Immunology at Children's Hospital in Pittsburgh, PA, USA. "Although sometimes mistakenly viewed as a trivial disease, allergic rhinitis can have a significant adverse impact on health in children as well as adults."

Dr. Skoner was one of six allergy specialists who spoke at The Nose and Beyond: New Perspectives on Pediatric Allergic Rhinitis, a roundtable discussion held Friday, December 11, in Barcelona. The roundtable, sponsored by Schering-Plough Pharmaceuticals, was organized to build awareness of pediatric allergic rhinitis among physicians and parents and to discuss optimal treatment strategies.

Allergic rhinitis is the most common chronic disease in children. About one in five children has symptoms by the age of 2 or 3 years, and up to 30% are affected during adolescence. The disease is triggered in susceptible children by allergic reactions to pollen, mold, dust mites and other offending allergens. In children, as in adults, allergic rhinitis causes symptoms such as nasal stuffiness, runny or itchy nose, and sneezing, all of which may range in severity from annoying to debilitating.

Allergic rhinitis can take a substantial toll on children's general well-being and school performance -- a fact that is not always appreciated by parents or healthcare providers. Children suffering from the disease may not sleep well or look well, which can lower their self-esteem, especially during adolescence. An estimated 1.5 million school days are lost each year due to allergic rhinitis. Even when children are at school, poorly treated allergic rhinitis can diminish their ability to learn, concentrate, and interact socially.

Left untreated, allergic rhinitis also can lead to a host of other serious conditions, including asthma, recurrent middle-ear infections, sinusitis, sleep disorders and chronic cough. "Appropriate management of rhinitis is an important part of effectively managing these co-existing or complicating respiratory conditions," said Dr. Skoner.

The roundtable expert panel, chaired by Dr. Soren Pedersen, Professor and Consultant, Pediatric Chest Physician at the University of Odense in Kolding, Denmark called for improved detection and treatment of pediatric allergic rhinitis. Although children with allergic rhinitis are advised to avoid allergens to minimize their symptoms, many also require medications such as glucocorticoid nasal sprays or nonsedating antihistamines.

"Intranasal glucocorticoids have been shown to be the most effective form of pharmacological treatment for allergic rhinitis," said roundtable participant Dr. Glenis K. Scadding, Consultant Physician in Clinical Immunology, Allergy and Rhinology at the Royal National Throat, Nose and Ear Hospital in London, England. "However, some clinicians are still reluctant to use these medications, because of worries about potential side effects." In addition, some patients may not comply with therapy due to confusion between anabolic steroids, which are sometimes abused to improve athletic performance, and glucocorticoids, whose efficacy and tolerability for treating allergic disorders has been well established in clinical practice worldwide.

The systemic safety of glucocorticoid nasal sprays is a concern, however, especially when treating children. There is potential for some of these medications to enter the bloodstream, and recent studies have shown that systemic glucocorticoids can affect bone metabolism and slow childhood growth. This potential adverse effect is of particular concern in children who require long-term glucocorticoid therapy via several routes of administration. For example, children with both allergic rhinitis and asthma may be treated with both an intranasal and an orally inhaled glucocorticoid, which may expose them to higher systemic concentrations of these drugs.

To meet the need for a glucocorticoid nasal spray with superior systemic safety, Schering-Plough has conducted an extensive clinical development program with NASONEX(R) an aqueous nasal spray containing the glucocorticoid mometasone furoate. NASONEX(R) is currently indicated for adults and adolescents 12 years of age and older for the prevention and treatment of seasonal allergic rhinitis, and the treatment of perennial allergic rhinitis. In adolescents and adults, NASONEX(R) has been shown to be highly effective and well tolerated in preventing or relieving symptoms of allergic rhinitis, with negligible potential for systemic exposure.

Recent published studies examining the use of NASONEX in children between 3 and 12 years of age found no detectable systemic effects of the medication after 2 weeks of treatment. According to Dr. Scadding, this extremely low potential for systemic effects makes NASONEX(R) an excellent choice for use in children with allergic rhinitis, particularly those who also take glucocorticoid medications for other ailments.

Schering-Plough Pharmaceuticals is the worldwide pharmaceutical research and marketing arm of Schering-Plough Corporation (NYSE: SGP), a research-based company engaged in the discovery, development, manufacturing and marketing of pharmaceutical and health care products worldwide.

CONTACT: Barbara Katz-Chobert of Trinity Communications, 610-832-2000, for Schering-Plough Pharmaceuticals