Fluticasone Furoate Nasal Spray is Effective and Well Tolerated for Perennial Allergic Rhinitis in Adolescents and Adults

Given, John; Cheema, Amarjit; Dreykluft, Tilman; Stillerman, Allan; Silvey, MaryJane; Wu, Wei; Snowise, Neil G; Philpot, E.

doi:10.2500/ajra.2010.24.3534

Cited by 15 publications

(9 citation statements)

References 35 publications

(94 reference statements)

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Donaldson

Choby

Kim

et al. 2020

Otolaryngol.--head neck surg.

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Objectives To address concerns related to the safety profile of both Food and Drug Administration (FDA)–approved and non–FDA-approved intranasal corticosteroid (INCS) use in the adult population. Data Source Systematic review of MEDLINE, PubMed, and EMBASE databases using a comprehensive search strategy including all INCS formulations and adverse events. The study design was developed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additional sources were identified from study references of relevant articles. Review Methods A structured literature search was conducted. Each study was graded for level of evidence using the Oxford Centre for Evidence-Based Medicine. Extracted data included population size, study design, drug (dosage, route, and frequency), presence of hypothalamus pituitary axis suppression, ocular symptoms, and treatment-related adverse events. Results A total of 60 studies met inclusion criteria. The studies included use of INCS as metered nasal sprays, drops, injections, aerosols, and irrigations. There were no persistent abnormalities in cortisol level or intraocular pressure change. Meta-analysis of epistaxis showed a significantly increased risk in the FDA-approved treatment group in comparison with control (risk ratio 1.56; 95% confidence interval, 1.13-2.14; P = .007). Conclusions Overall, it appears that the use of both FDA and published non-FDA application of INCS are safe in the adult population. Meta-analysis demonstrated an increased risk of epistaxis in patients using INCS compared with placebo. Otherwise, there was no significant difference between in adults in the treatment group and placebo group. As an important caveat, the interpretation of safety of nonstandard INCS is restricted to delivery methods and dosages published in the literature.

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Section: Resultsmentioning

confidence: 99%

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

Donaldson

Choby

Kim

et al. 2020

Otolaryngol.--head neck surg.

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“…16-21 The risk ratio for patients treated with fluticasone furoate was 1.85 (95% CI, 1.46-2.34; I 2 = 0%; Figure 5 ). 22-36 The risk ratio for patients treated with mometasone furoate was 1.48 (95% CI, 1.06-2.07; I 2 = 3%; Figure 6 ). 37-50 Fluticasone propionate was associated with an intermediate risk ratio of 1.36 (95% CI, 1.00-1.85; I 2 = 0%; Figure 7 ).…”

Section: Resultsmentioning

confidence: 99%

Epistaxis Risk Associated with Intranasal Corticosteroid Sprays: A Systematic Review and Meta‐analysis

Harris

Babcock

et al. 2019

Otolaryngol.--head neck surg.

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Objective Intranasal corticosteroids (INCSs) are widely utilized for the treatment of allergic rhinitis. Epistaxis is a known adverse effect of INCSs, but it is not known if the risk of epistaxis differs among INCSs. Data Sources Systematic review of primary studies identified through Medline, Embase, Web of Science, PubMed Central, and Cochrane databases. Review Methods Systematic review was conducted according to the PRISMA standard. English-language studies were queried through February 1, 2018. The search identified randomized controlled trials of INCSs for treatment of allergic rhinitis that reported incidence of epistaxis. An itemized assessment of the risk of bias was conducted for each included study, and meta-analysis was performed of the relative risk of epistaxis for each INCS. Results Of 949 identified studies, 72 met the criteria for analysis. Meta-analysis demonstrated an overall relative risk of epistaxis of 1.48 (95% CI, 1.32-1.67) for all INCSs. The INCSs associated with the highest risk of epistaxis were beclomethasone hydrofluoroalkane, fluticasone furoate, mometasone furoate, and fluticasone propionate. Beclomethasone aqueous, ciclesonide hydrofluoroalkane, and ciclesonide aqueous were associated with the lowest risk of epistaxis. Conclusions about epistaxis with use of budesonide, triamcinolone, and flunisolide are limited due to the low number of studies and high heterogeneity. Conclusions While a differential effect on epistaxis among INCS agents is not clearly demonstrated, this meta-analysis does confirm an increased risk of epistaxis for patients using INCSs as compared with placebo for treatment of allergic rhinitis.

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“…Several studies of INS treatments have looked at their impact on quality of life [17–21]. INS therapies have generally been reported to have a clinically meaningful improvement in QoL, as measured by the Rhinoconjunctivitis Quality of Life Questionnaire, compared to placebo.…”

Section: Introductionmentioning

confidence: 99%

Burden of illness and quality of life in patients being treated for seasonal allergic rhinitis: a cohort survey

Small

Piercy

Demoly

et al. 2013

Clinical & Translational All

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BackgroundAllergic Rhinitis is an inflammatory disease which is characterised by burdensome nasal and/or ocular symptoms. This study aimed to assess the impact of symptoms (number of symptom-free days (SFD) and Quality of Life (QoL)) in patients with Seasonal Allergic Rhinitis (SAR) being treated with fluticasone furoate (FF), mometasone furoate (MF) or fluticasone propionate (FP).MethodsIn a cross-sectional, non-interventional, cohort analysis, primary care physicians and allergy specialists in France, Germany, and Spain were recruited via telephone interviews. Each physician prospectively recruited 4 SAR patients - 2 receiving FF, 1 receiving MF and 1 receiving FP - during June 2009. Patients answered questions on symptoms and completed questionnaires on QoL (mini-rhinoconjunctivitis Quality of Life Questionnaire, RQLQ) and burden of illness (Pittsburgh Sleep Quality Index).ResultsA total of 540 patients were recruited during June 2009. 88 patients were subsequently found to be ineligible and excluded from the analyses. In the 4 weeks prior to assessment, patients reported a mean of 14.58 (±8.42) SFD. Patients receiving FF had more SFD (mean 15.45 ±8.29) than patients receiving MF (adjusted mean difference -1.22, 95% Confidence Interval (CI) [-3.16 to 0.72], p=0.434) or FP (adjusted mean difference -1.95, 95% CI [-3.87 to -0.03], p=0.092), although statistical significance was not achieved. The mean RQLQ score was 1.54 (±1.06). Patients receiving FF had a better quality of life in the previous week (mini-RQLQ score: mean 1.42, ±1.04) than patients receiving MF (adjusted mean difference 0.28, 95% CI [0.03 to 0.52], p=0.052) or FP (adjusted mean difference 0.18, 95% CI [-0.05 to 0.41], p=0.244). Again, none of these results achieved statistical significance.ConclusionsAt the height of the allergy season, patients with SAR suffer symptoms approximately 50% of the time, and report an impact on their QoL. No significant differences were observed between FF, FP and MF related to SFD or QoL.Trial registrationClinicalTrials.gov identifier: NCT01199757

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Fluticasone Furoate Nasal Spray is Effective and Well Tolerated for Perennial Allergic Rhinitis in Adolescents and Adults

Abstract: Once-daily FFNS was well tolerated and more effective than placebo at improving nasal symptoms of perennial allergic rhinitis in adolescents and adults ≥12 years of age.

Cited by 15 publications

References 35 publications

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

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

Epistaxis Risk Associated with Intranasal Corticosteroid Sprays: A Systematic Review and Meta‐analysis

Burden of illness and quality of life in patients being treated for seasonal allergic rhinitis: a cohort survey

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