Absence of Nasal Mucosal Atrophy With Fluticasone Aqueous Nasal Spray

Abstract

Treatment with intranasal fluticasone for 1 year increases the thickness of the nasal epithelium as compared with a year's treatment with terfenadine and does not lead to atrophy in the nasal mucosa. The increased thickness in the fluticasone treatment may represent repair from epithelial damage caused by chronic allergic inflammation.

The diagnosis and management of rhinitis: An updated practice parameter

“…618,940,941 Evaluation of the histologic and macroscopic appearance of the nasal mucosa after administration of intranasal corticosteroids has shown no deleterious pathological changes from that after placebo or antihistamines. 618,942 In vitro and some in vivo studies have shown that benzalkonium chloride alone, and in 1 clinical study, a corticosteroid nasal spray containing benzalkonium chloride, can promote ciliary stasis and reduce mucociliary transport. 414,415 Oral corticosteroids 81.…”

“…Nasal steroids, however, may be safely used for treatment of allergic rhinitis, because they do not cause any clinical or histologic atrophic changes in the nasal mucosa. 618 Rhinitis in the elderly may also be a result of cholinergic hyperreactivity, associated with profuse watery rhinorrhea, which may be aggravated after eating (gustatory rhinitis), a-adrenergic hyperactivity (eg, congestion associated with therapy for hypertension or benign prostatic hypertrophy), or chronic sinusitis. The watery rhinorrhea syndrome frequently responds to intranasal ipratropium bromide.…”

The Effect of Topical Corticosteroids, Topical Antihistamines, and Preservatives on Human Ciliary Beat Frequency

“…These findings provide further evidence that the intrinsic nasal protective effects, including the nasal mucus barrier function, the mucus diluting effect of the nasal medication, and the effect of mucus pH on nasal drug activity, can compensate in vivo for toxic effects observed with these drugs in vitro. In fact, a number of studies have corroborated the preservation or even improvement of nasal mucosa structure after long-term administration of these intranasal sprays [14,15]. Indeed, some studies have addressed the long-term or short-term effect of certain intranasal steroids on ciliary function in allergic rhinitis patients, by assessing indigocarmine saccharine or radiotracer clearance from the nose as indicators of CBF, and demonstrated no significant impairment of mucociliary function [16,17].…”

A novel N-chlorotaurine–corticosteroid combination as a preservative-free local disinfectant: Influence on the ciliary beat frequency in vitro

“…Therefore it is not clear if this was the reason for the decrease in CBF or if it was the result of a direct drug effect and if there is also a ciliotoxic effect in vivo, when the substance is diluted by nasal secretion. In a number of previous clinical studies [11Á/14], good tolerability was demonstrated when FP was applied for 1 year and there were no signs of epithelial atrophy [11].…”