Background: Intranasal sprays are recommended as targeted therapy for allergic rhinitis (AR). Triamcinolone acetonide is a nasal corticosteroid preparation indicated for the treatment of seasonal and perennial AR (PAR) in different countries worldwide. Objectives: In order to determine the efficacy of triamcinolone acetonide in the treatment of PAR, the non-inferiority of triamcinolone acetonide to fluticasone propionate was assessed in Russian adults. Methods: In this randomized, double-blind, parallel-group, multicenter, prospective, non-inferiority, phase III clinical trial, a total of 260 patients with persistent PAR were randomized to receive either triamcinolone acetonide or fluticasone propionate nasal sprays for 4 weeks. The efficacy in symptom control was evaluated using the reflective total nasal symptom score (rTNSS) from baseline (day 0) to day 28. Safety was assessed through the reporting of adverse events. Results: The rTNSS mean values decreased from baseline to the end of study treatment (day 28) in both groups: –8.2 ± 3.0 in the triamcinolone acetonide arm versus –8.0 ± 2.8 in the fluticasone propionate arm. The mean difference between the groups (triamcinolone acetonide – fluticasone propionate) for rTNSS change from baseline was –0.2 (95% confidence interval –0.89 to 0.54), with an upper confidence limit of 0.54, which is lower than the non-inferiority margin of 0.8. Triamcinolone acetonide was well tolerated, with no difference in adverse event occurrence compared with fluticasone propionate. Conclusions: Triamcinolone acetonide proved to be non-inferior to fluticasone propionate in adult patients with PAR; both treatments decreased rTNSS values and showed a good safety profile.

В современном мире инфекции верхних дыхательных путей и ЛОР-органов занимают первое место в структуре общей заболеваемости в мире, а удельный вес данной патологии составляет у взрослых 27,6%, у подростков-39,9% и у детей-61% [4]. Неутешительные данные статистики обусловливают неугасающий интерес к данной проблеме в практической медицине.

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Significant role of getting the required amount of air into the human body belongs to the breathing by the nose. The nasal cavity prepares the air for reciprocity with the lower respiratory tract owing to the complex structure of the mucous membrane. When nasal obstruction occurs, breathing is carried out mainly through the mouth, and there is a violation of the basic functions of the nose, as well as the ingress of unadapted aggressive air to the sensitive alveolar structures of the lungs. This leads first to functional, and then to morphological and structural changes. In addition, difficult nasal breathing leads to impaired aeration of the paranasal cavities, middle ear cavity and hypoxia of all organs of the body. Even short episodes of nasal obstruction affect the quality of life, and prolonged untreated or incorrectly treated acute viral rhinosinusitis can spill over into lingering bacterial diseases of the ENT organs. Decongestants are used to eliminate nasal congestion. Decongestants include a wide range of substances that are used topically or systemically, in the form of monotherapy or in combination with other substances. The most popular drugs in this group are topical decongestants, since they have the most pronounced effect. The main nasal decongestants can be divided into two groups: sympathomimetic amines: primary aliphatic; phenolic and non-phenolic compounds, as well as imidazoline derivatives. Among the modern vasoconstrictor drugs oxymetazoline. Using it strictly according to the instructions within 3–5 days guarantees the absence of the development of local and systemic complications.

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