H. Hallen et al., FLUTICASONE PROPIONATE NASAL SPRAY IS MORE EFFECTIVE AND HAS A FASTERONSET OF ACTION THAN PLACEBO IN TREATMENT OF RHINITIS MEDICAMENTOSA, Clinical and experimental allergy, 27(5), 1997, pp. 552-558
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.