Local safety of intranasal triamcinolone acetonide: clinical and histological aspects of nasal mucosa in the long term treatment of perennial allergic rhinitis

Intranasal corticosteroids are increasingly used to treat allergic rhinitis and their long-term use is generally safe. However, the long-term safety o f each molecule should be assessed. The main aim of this multicenter, prosp ective, randomized, open-label study was to evaluate the effect of triamcin olone acetonide aqueous intranasal spray on nasal mucosal thickness, macros copic appearance, and mucociliary function. Patients with perennial allergi c rhinitis were treated with triamcinolone acetonide 220 mug/day six months . Nasal biopsies taken before and after treatment were compared with biopsi es from patients who had been randomized to oral cetirizine 10 mg day or in tranasal beclomethasone dipropionate 400 mug/day. In the evaluable populati on (n=70), there were no significant differences between groups in terms of histologically evaluated thickness and endoscopically evaluated macroscopi c appearance of the nasal mucosa, or indigocarmine saccharine test mucocili ary function. In the intent-to-treat population (n=92), there was no differ ence between treatment groups in the incidence of overall adverse events. T his study indicates that sustained treatment with intranasal triamcinolone acetonide does not lead to atrophy of the nasal mucosa or impairment of muc ociliary function.