A patient preference and satisfaction study of ciclesonide nasal aerosol and mometasone furoate aqueous nasal spray in patients with perennial allergic rhinitis

Abstract

Patients' preference and satisfaction with their nasal allergy medications may be influenced by their sensory attributes. This study evaluates patient preference and satisfaction with ciclesonide hydrofluoroalkane nasal aerosol (CIC-HFA) compared with mometasone furoate aqueous nasal spray (MFNS). Symptomatic subjects with perennial allergic rhinitis (PAR) were randomized to CIC-HFA at 74 micrograms or MFNS at 200 micrograms q.d. in an open-label, two-period, crossover study. Subject preference was recorded as total preference score (TPS; average of 17 individual preference items) at the end of treatment period 2, and satisfaction was assessed with a 76-item, self-administered instrument at baseline and at the end of each 2-week treatment period. The primary assessments were TPS and regimen attributes composite satisfaction score composed of two of nine satisfaction subscales: sensory impact (including medication running out of the nose, medication running down the throat, and impact on smell and taste) and regimen management (comprised of issues relating to dosing and ability to remember to take medication). Two hundred ninety-four subjects completed the study. A total of 68.1% of subjects preferred CIC-HFA (p < 0.0001 versus MFNS), with a mean TPS of 68.3 versus 31.7 for the MFNS group. The regimen attributes composite satisfaction score significantly (p < 0.0001 for each treatment period) favored CIC-HFA versus MFNS at the end of treatment period 1 (85.5 vs 77.6) and treatment period 2 (83.0 versus 73.5), respectively. In this study, subjects reported higher preference for and satisfaction with CIC-HFA compared with MFNS, suggesting significant differences in patient perception of attributes in favor of CIC-HFA. Clinical trial registration URL and registration number: www.clinicaltrials.gov/ct2/show/NCT01401465.

Intranasal Corticosteroid Therapy: Systematic Review and Meta‐analysis of Reported Safety and Adverse Effects in Adults

“…However, an open-label randomized crossover study found a similar incidence of epistaxis when comparing ciclesonide hydrofluoroalkane and mometasone furoate: 2.3% and 1.3%, respectively. 20 Our study supports this finding, as we noted that all 4 studies looking at (ciclesonide hydrofluoroalkane) reported epistaxis as an adverse event. 19,20,33,38 The studies using non–FDA-approved INCS did not include epistaxis as a complication of medication usage.…”

“…Epistaxis was noted in more than half of the articles included in our study. 16-49 The most commonly reported medications with this drug effect include fluticasone propionate, fluticasone furoate, and mometasone furoate. However, an open-label randomized crossover study found a similar incidence of epistaxis when comparing ciclesonide hydrofluoroalkane and mometasone furoate: 2.3% and 1.3%, respectively.…”

The Clinical Pharmacology of Past, Present, and Future Glucocorticoids

“…Regarding local effects, a recent study demonstrated that ciclesonide, a pro-drug, has local adverse effects similar to mometasone, which is not a pro-drug [ 7 ], suggesting that clinical translation of preclinical data is not necessarily linear. In conclusion, it is diffi cult at present to establish which new-generation GC should be the fi rst choice.…”

Turkish Guidelines for Diagnosis and Treatment of Allergic Rhinitis (ART)

“…A first generation corticosteroid, dexamethasone, is no longer preferred due to its side effects ( 452 ). The second generation corticosteroids, including beclomethasone dipropionate (aerosol) ( 453 - 460 ), budesonide (aqueous) ( 461 - 463 ), ciclesonide (aqueous or aerosol) ( 464 - 466 ), flunisolide (aqueous), fluticasone furoate (aqueous) ( 467 - 470 ), fluticasone propionate (aqueous) ( 471 - 474 ), triamcinolone acetonide (aqueous) ( 475 - 476 ) and mometasone furotate (aqueous) ( 466 , 477 - 482 ) have been used in nasal spray preparations until today.…”