Nasally administered dexamethasone aerosols have been shown to suppress hay fever symptoms in about 75 per cent of patients with ragweed hay fever. To determine whether symptomatic improvement is due to the local action of the steroid in the nose, or is due to systemic absorption, seasonal symptoms were compared in ragweed patients who received either the nasal aerosol or an oral dose of steroid with equivalent metabolic effect. Control of symptoms in patients receiving the nasal steroid was again excellent, but control of symptoms in patients receiving orally the metabolic equivalent of dexamethasone was no better than in patients receiving placebos. The effect of the nasal steroid spray appears to depend, therefore, upon local application in the nose.
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