ONCE-DAILY INTRANASAL FLUTICASONE PROPIONATE IS EFFECTIVE FOR PERENNIAL ALLERGIC RHINITIS

The efficacy of intranasal fluticasone propionate 200 mu g once daily or 100 mu g twice daily in treating perennial allergic rhinitis was ev aluated in a randomized, double-blind, placebo-controlled study of 24 weeks' duration in 365 patients. Clinician-rated and patient-rated tot al nasal symptom severity scores were improved within I week of treatm ent with either regimen of fluticasone propionate and improvement was maintained over the 24-week treatment period. Clinician-rated overall evaluation indicated a significantly better response in the two flutic asone propionate groups compared with the placebo group. All efficacy evaluations indicated no difference in response between the fluticason e propionate 200 mu g once-daily and 100 mu g twice-daily groups. Pati ents in both fluticasone propionate groups had significantly less nasa l obstruction upon awakening than the placebo group at all assessment periods. Fewer patients in either fluticasone propionate group used an tihistamine rescue medication compared with the placebo group. The per centage of patients with nasal eosinophils and basophils at the end of the 24-week treatment period was significantly lower in both fluticas one propionate groups compared with the placebo group. Safety evaluati ons indicated that intranasal fluticasone propionate was as safe as pl acebo when given as 200 mu g once daily or 100 mu g twice daily. The i ncidence of drug-related adverse events was similar among the fluticas one propionate and placebo groups except for the incidence of epistaxi s and blood in nasal mucus which was somewhat higher in the fluticason e propionate twice-daily group. There were no changes in the ophthalmi c examinations to suggest corticosteroid-induced posterior subcapsular cataract formation. Fluticasone propionate did not appear to affect t he hypothalamic-pituitary-adrenal axis as determined by morning plasma cortisol concentrations and response to cosyntropin stimulation. Long -term administration of intranasal fluticasone propionate 200 mu g onc e daily is an effective and well-tolerated treatment for perennial all ergic rhinitis.