Intranasal steroids do not appear to increase the risk of developing cataracts, according to researchers from the UK and the US. Dr Laura Derby (Boston collaborative drug surveillance programme, Massachusetts, US) and Dr William Maier (Glaxo-Wellcome) state in the Journal of Allergy and Clinical Immunology (2000;105:912) that patients receiving oral steroids are known to be at risk of developing cataracts but that, until now, the risk for those using intranasal steroids has been unknown.
To investigate the risk, the researchers examined the UK General Practice Research Database. They found medical records of 88,301 patients using intranasal steroids and 98,901 who were taking oral steroids. The incidence of cataract development was compared with that for 98,786 patients who had had no exposure to steroids. The number of cases of cataract for each group were 217, 629 and 213 respectively. This equated to incidence rates of 1, 2.2 and 1 per 1,000 for each of the three groups.
The incidence figures did not increase significantly with increasing numbers of prescriptions in the intranasal group but did in the oral group. Approximately 70 per cent of intranasal exposure was to beclomethasone dipropionate.