FLUTICASONE PROPIONATE NASAL SPRAY IS MORE EFFECTIVE AND HAS A FASTERONSET OF ACTION THAN PLACEBO IN TREATMENT OF RHINITIS MEDICAMENTOSA

Background Controversy still exists about the treatment of rhinitis me dicamentosa and treatment has never been objectively evaluated. Object ive To study the effect of fluticasone propionate aqueous nasal spray compared to placebo nasal spray in the treatment of rhinitis medicamen tosa. Methods A parallel randomized, double-blind study was conducted to evaluate the treatment of rhinitis medicamentosa. Two groups contai ning 10 patients with rhinitis medicamentosa in each group stopped the ir overuse of nasal vasoconstrictor spray immediately and were treated with either fluticasone propionate nasal spray once daily 200 mu g, o r placebo nasal spray for 14 days. The nasal mucosal swelling was reco rded with rhinostereometry, acoustic rhinometry and a peak inspiratory flow meter. Nasal stuffiness was estimated on a visual analogue scale in the morning and in the evening of each day. Results The mucosal sw elling decreased after 7 and 14 days of treatment with fluticasone pro pionate as well as placebo, but the reduction was significantly greate r after treatment with fluticasone propionate. The symptom scores for nasal stuffiness showed a marked reduction during the treatment period in both groups, but there was a faster onset of symptom reduction aft er treatment with fluticasone propionate. Conclusion Fluticasone propi onate is more effective and has a faster onset of action than placebo in the treatment of rhinitis medicamentosa. An adequate treatment of t hese patients consists of a combination of vasoconstrictor withdrawal and a topical corticosteroid to alleviate the withdrawal process.