ODISTR: A Novel Pediatric Asthma Management Strategy using On-Demand Intranasal Steroids

Dr. Rajatsubhra Mukhopadhyay

Pediatrician and Integrative Medicine Researcher

Child Health Care Arambag (CHCA), West Bengal, India

President, Sri Yoga Center Trust – Kunarpur

ORCID ID: 0000-0001-5658-8016

Abstract

ODISTR (On Demand INTRANASAL STEROID THERAPY of Rajatsubhra) is a novel, non-invasive management strategy for pediatric asthma and allergic rhinitis. Developed over a decade of observation and clinical experience, ODISTR emphasizes the targeted, short-course use of intranasal corticosteroids (like mometasone or fluticasone) during early prodromal phases of exacerbation, triggered by environmental allergens or viral infections.

This approach significantly reduces the need for long-term oral or inhalational steroids, minimizes systemic side effects, and improves compliance in pediatric patients. ODISTR also enhances asthma control when combined with allergen avoidance strategies based on skin prick or serum IgE allergy testing.

Keywords

Asthma, Pediatric, Intranasal Steroids, Allergic Rhinitis, ODISTR, On-demand therapy, Mometasone, Non-invasive treatment, Rajatsubhra Mukhopadhyay, West Bengal innovation

Background

Conventional asthma protocols often rely on continuous use of inhaled corticosteroids (ICS), leukotriene receptor antagonists (e.g., montelukast), and beta-agonists. However, in resource-limited rural setups, adherence to continuous ICS therapy is challenging.

ODISTR

This was conceptualized as a minimal-intervention protocol where the nasal mucosa is used as a steroid entry point during early phases of exacerbation. This leverages both local anti-inflammatory and systemic modulation of airway inflammation with short bursts of mometasone nasal spray (100 mcg once daily for 3–5 days). It is given only during early signs (e.g., runny nose, sneezing, early cough), especially when associated with seasonal exposure or viral triggers.

Method Summary

- Medication: Mometasone furoate nasal spray (100 mcg per spray)

- Dosage: 1 spray in each nostril once daily for 3–5 days

- When to use:

   - Start at first sign of allergic rhinitis or upper respiratory infection

   - Use seasonally when allergens are expected

   - Avoid if febrile or purulent nasal discharge exists

- Adjunct: Antihistamines (e.g., levocetirizine or fexofenadine), Montelukast if needed

Clinical Observations (2010–2024)

- Over 350+ children treated

- Significant reduction in severe exacerbations

- Lower usage of inhaled steroids and salbutamol

- Improved sleep and school attendance

- No reported adverse events in observed cases

- Particularly effective in allergic rhinitis-asthma overlap

References

1. Mukhopadhyay R. Intranasal Steroid and Asthma. ResearchGate, 2013.

   https://www.researchgate.net/publication/309618575

2. Mukhopadhyay R. Avoiding Inhaler Steroid in Children with Asthma through On Demand Nasal Steroid Use. Texila American Journal of Medicine, 2023.

   https://www.texilajournal.com/medicine/edition/27-volume1-issue1

3. ORCID Profile: https://orcid.org/0000-0001-5658-8016

License

This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).