AAPA-AAI Position Statement on Intranasal Corticosteroid Concerns
July 19, 2013
TO: The U.S. Food & Drug Administration
FROM: The American Academy of Physician Assistants in Allergy, Asthma, & Immunology (AAPA-AAI)
RE: Concerns about intranasal corticosteroids for over-the counter use
On behalf of the members of the American Academy of Physician Assistants in Allergy, Asthma, and Immunology (AAPA-AAI), I am writing to state that we are recommending that intranasal corticosteroids remain prescription-only drugs.
The position statement that our members support is also what has been recommended by our physician colleagues through a joint task force position statement published in the Annals of Allergy, Asthma & Immunology.2006;96:514-525. The joint task force was made up of physicians who are members of the American Academyof Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology. The concerns made by our physician colleagues are the same concerns that our members, as physician assistants and prescribers of medications in allergy, also have. As with any medication, there is the potential for over usage and due to the side effects of corticosteroid usage, they need to be monitored by a properly trained health care professional who can monitor effects on growth, effects such as cataracts and glaucoma in the eyes, effects on the bone (especially when administered with other corticosteroids), effects on the hypothalamic-pituitary axis, and local adverse effects, including nasal septum perforation. As stated in the joint task force position statement conclusion, “adverse effects can be insidious and therefore not evident for many years; there is the potential for overuse; patients could also have access to other forms of topically administered corticosteroids, thus increasing their total dosage; and individuals vary in their susceptibility to corticosteroid-induced adverse effects.”
As clinicians who regularly take care of patients in the allergy, asthma and immunology specialty, we observe first hand over usage of medications. We understand the potential for harm when these types of medications are not monitored frequently. We recommend that intranasal corticosteroids remain prescription-only medications.
Thank you for your consideration.
Susan Symington, DFAAPA, MPAS, PA-C
Arizona Allergy and Asthma Institute
Glendale, AZ 85308