Relief of cough and nasal symptoms associated with allergic rhinitis by mometasone furoate nasal spray

Gawchik, Sandra M.; Goldstein, Stanley; Prenner, Bruce M.; John, Ani

doi:10.1016/s1081-1206(10)61826-1

Cited by 86 publications

(68 citation statements)

References 8 publications

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“…Consequently, 17 evaluations on TNSS were included (10 interventional studies comparing MFNS vs placebo for the treatment of AR in 1878 adults (17-19, 21, 49-54); one RCT evaluating 271 children (24); five studies assessing postchallenge effects on TNSS in 634 participants (17,(55)(56)(57)(58) and one study commenced treatment 4 weeks preseasonally (n = 215) (20). Data on the individual nasal symptom scores were available in seven studies including 1582 subjects (19,21,(49)(50)(51)(52)54). Nonnasal symptom scores were assessed in four studies (n = 1009) (21, 49, 51, 52) and nasal airflow in three studies (n = 271) (17,50,53).…”

Section: Search Resultsmentioning

confidence: 99%

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Penagos

Compalati

Tarantini

et al. 2008

Allergy

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Rationale: Several randomized, double‐blind, placebo‐controlled clinical trials have demonstrated the efficacy of mometasone furoate nasal spray (MFNS) in the treatment of allergic rhinitis (AR) thus allowing for a meta‐analysis to determine the overall treatment effect.Methods: A comprehensive search of the MEDLINE, LILACS, SCOPUS, and the Cochrane Library databases up to 31 October, 2007 was carried out. Randomized, double‐blind, placebo‐controlled, clinical trials evaluating the efficacy of MFNS in patients with AR compared to placebo were included. Total nasal symptom scores (TNSS), individual nasal symptoms, total non‐nasal symptom scores (TNNSS) and nasal airflow were analysed as the standardized mean difference (SMD). Meta‐analysis was performed with the random or the fixed effect models depending on heterogeneity, by using revman 5 software.Data synthesis: Sixteen of the 113 identified articles met the inclusion criteria. For MFNS efficacy on TNSS, 2998 participants were analysed: 1534 received MFNS and 1464 placebo. Mometasone furoate nasal spray was associated with a significant reduction in TNSS (SMD −0.49, 95% CI: −0.60 to −0.38; P < 0.00001; I2 = 50.1%). A significant effect on SMD for nasal stuffiness/congestion (−0.41; 95% CI: −0.56 to −0.27), rhinorrhoea (−0.44; 95% CI: −0.66 to −0.21), sneezing (−0.40; 95% CI: −0.57 to −0.23) and nasal itching (−0.39; 95% CI: −0.53 to −0.25) was also demonstrated. Mometasone furoate nasal spray treated subjects also showed a significant reduction in TNNSS (−0.30; 95% CI: −0.43 to −0.18). The proportion of patients with adverse events was similar for MFNS and placebo (0.99; 95% CI: 0.81–1.20; P = 0.91).Conclusions: This meta‐analysis provides a level Ia evidence for the efficacy of MFSN in the treatment of AR vs placebo. Adverse events frequency was similar in both groups.

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Section: Search Resultsmentioning

confidence: 99%

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Penagos

Compalati

Tarantini

et al. 2008

Allergy

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“…74 As would be expected, based on their mechanism of action and demonstrated benefit in improving sleep in AR patients, INS significantly reduce most night-time nasal symptoms of AR, as demonstrated by the effect of mometasone furoate nasal spray (MFNS) in a large doubleblind, placebo-controlled, parallel-group trial of 245 patients with seasonal AR. 73 Once-daily treatment with MFNS produced significant improvement in night-time symptoms of congestion, nasal itching, and sneezing ( Figure 3a) and in all individual daytime symptoms (cough, rhinorrhea, congestion, nasal itching, and sneezing) (Figure 3b). The baseline mean night-time total nasal symptom score was higher for the MFNS group compared with the placebo group (9.3 vs 8.8; p=0.04).…”

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confidence: 98%

“…Indeed, this has been demonstrated in several clinical studies, based both on subjective daily diary data and on several validated instruments assessing sleep quality, sleep-related QOL, and nocturnal rhinitis-related QOL (see Table 2). 23,24,[71][72][73][74][75][76][77][78][79][80] Two small similarly-designed placebo-controlled crossover trials in patients with perennial AR demonstrated significant trends toward improvements in nasal congestion, subjective sleep, and daytime somnolence (as recorded in daily diaries) with INS (flunisolide in one study and budesonide in the other) vs placebo (Figure 2). 23,24 The INS fluticasone has also significantly improved subjective sleep quality vs placebo (p=0.04) in 32 patients with perennial AR and chronic sleep problems.…”

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confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems.In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators -and therefore nasal congestion and other symptoms -should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

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“…16 Conversely, not all patients with 'PND' have cough as in one study where out of 108 patients with purulent post nasal secretions attending a rhinology clinic, only 21% complained of cough. 13 In a study by Gawchik et al, 17 patients with a history of PND were enrolled into a double-blind study to receive rabeprazole or placebo for 90 days. The aim of the study was to look at the relationship between extra-oesophageal reflux and PND.…”

Section: Relationship Between Cough and Gord And Pndmentioning

confidence: 99%

Rhinosinusitis, laryngopharyngeal reflux and cough: An ENT viewpoint

Saleh

2009

Pulmonary Pharmacology & Therapeutics

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Chronic cough is a common presentation. Post nasal drip (PND) and gastro-oesophageal reflux are mostly implicated in the aetiology. Directly examining the larynx can often help to demonstrate laryngitis or inter-arytenoid oedema that is mostly attributed to reflux. Although "the syndrome of postnasal drip" is considered as a major cause for chronic cough, evidence of its existence is mostly difficult to elicit on examination. Furthermore, the majority of patients with "postnasal drip" seen in ENT outpatients do not complain of cough. Evidence does suggest there is a link between post nasal drip and cough. The fact that some patients present with cough in association with this syndrome and others do not is still not well understood.

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Relief of cough and nasal symptoms associated with allergic rhinitis by mometasone furoate nasal spray

Cited by 86 publications

References 8 publications

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Rhinosinusitis, laryngopharyngeal reflux and cough: An ENT viewpoint

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