G J Rodrigo1, H Neffen. 1. Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay Unidad de Medicina Respiratoria, Hospital de Niños O. Alassia, Santa Fe, Argentina. gurodrig@adinet.com.uy
Abstract
BACKGROUND: Although previous data suggest that intranasal fluticasone furoate (FF) improves ocular symptoms of allergic rhinitis (AR), it presents serious limitations that question its results and conclusions. Therefore, an independent systematic review with meta-analysis is required to confirm and clarify the magnitude of the effect of FF. METHODS: This review compared the efficacy of intranasal FF to placebo on ocular and nasal symptoms in patients with AR. Primary outcomes were reflective and instantaneous total ocular symptom scores (rTOSS and iTOSS), and reflective and instantaneous total nasal symptom scores (rTNSS and iTNSS). Secondary outcomes included the assessment of response to therapy, quality of life (QoL), and adverse effects. RESULTS: Sixteen trials (5.348 patients) were selected. Seven studies included seasonal AR patients and nine studies, perennial AR patients. Intranasal FF significantly improved rTOSS and iTOSS scores compared with placebo in patients with seasonal (weighted mean difference [WMD] -0.54, 95% CI, -0.70 to -0.37, and -0.59, 95% CI, -0.76 to -0.43) and perennial AR (-0.33, 95% CI, -0.31 to -0.05, and -0.38, 95% CI, -0.69 to -0.07). Intranasal FF was also significantly more effective in improving rTNSS and iTNSS scores in seasonal (WMD=-1.14, 95% CI, -1.57 to -0.72, and -1.32, 95% CI, -1.64 to -1.01) and perennial AR patients (-0.83, 95% CI, -1.08 to -0.59, and -0.90, 95% CI, -1.33 to -0.48). Finally, there were greater improvements in response to therapy and QoL with a favourable safety profile. CONCLUSIONS AND CLINICAL RELEVANCE: Intranasal FF showed a consistent ocular and nasal efficacy along with improvement in QoL in AR patients. This review provides significant evidence that treatment with FF nasal spray at a dose of 110 mcg once daily is effective in relieving ocular and nasal symptoms in adolescents and adults with AR.
BACKGROUND: Although previous data suggest that intranasal fluticasone furoate (FF) improves ocular symptoms of allergic rhinitis (AR), it presents serious limitations that question its results and conclusions. Therefore, an independent systematic review with meta-analysis is required to confirm and clarify the magnitude of the effect of FF. METHODS: This review compared the efficacy of intranasal FF to placebo on ocular and nasal symptoms in patients with AR. Primary outcomes were reflective and instantaneous total ocular symptom scores (rTOSS and iTOSS), and reflective and instantaneous total nasal symptom scores (rTNSS and iTNSS). Secondary outcomes included the assessment of response to therapy, quality of life (QoL), and adverse effects. RESULTS: Sixteen trials (5.348 patients) were selected. Seven studies included seasonal AR patients and nine studies, perennial AR patients. Intranasal FF significantly improved rTOSS and iTOSS scores compared with placebo in patients with seasonal (weighted mean difference [WMD] -0.54, 95% CI, -0.70 to -0.37, and -0.59, 95% CI, -0.76 to -0.43) and perennial AR (-0.33, 95% CI, -0.31 to -0.05, and -0.38, 95% CI, -0.69 to -0.07). Intranasal FF was also significantly more effective in improving rTNSS and iTNSS scores in seasonal (WMD=-1.14, 95% CI, -1.57 to -0.72, and -1.32, 95% CI, -1.64 to -1.01) and perennial AR patients (-0.83, 95% CI, -1.08 to -0.59, and -0.90, 95% CI, -1.33 to -0.48). Finally, there were greater improvements in response to therapy and QoL with a favourable safety profile. CONCLUSIONS AND CLINICAL RELEVANCE: Intranasal FF showed a consistent ocular and nasal efficacy along with improvement in QoL in AR patients. This review provides significant evidence that treatment with FF nasal spray at a dose of 110 mcg once daily is effective in relieving ocular and nasal symptoms in adolescents and adults with AR.
Authors: Sarah K Wise; Sandra Y Lin; Elina Toskala; Richard R Orlandi; Cezmi A Akdis; Jeremiah A Alt; Antoine Azar; Fuad M Baroody; Claus Bachert; G Walter Canonica; Thomas Chacko; Cemal Cingi; Giorgio Ciprandi; Jacquelynne Corey; Linda S Cox; Peter Socrates Creticos; Adnan Custovic; Cecelia Damask; Adam DeConde; John M DelGaudio; Charles S Ebert; Jean Anderson Eloy; Carrie E Flanagan; Wytske J Fokkens; Christine Franzese; Jan Gosepath; Ashleigh Halderman; Robert G Hamilton; Hans Jürgen Hoffman; Jens M Hohlfeld; Steven M Houser; Peter H Hwang; Cristoforo Incorvaia; Deborah Jarvis; Ayesha N Khalid; Maritta Kilpeläinen; Todd T Kingdom; Helene Krouse; Desiree Larenas-Linnemann; Adrienne M Laury; Stella E Lee; Joshua M Levy; Amber U Luong; Bradley F Marple; Edward D McCoul; K Christopher McMains; Erik Melén; James W Mims; Gianna Moscato; Joaquim Mullol; Harold S Nelson; Monica Patadia; Ruby Pawankar; Oliver Pfaar; Michael P Platt; William Reisacher; Carmen Rondón; Luke Rudmik; Matthew Ryan; Joaquin Sastre; Rodney J Schlosser; Russell A Settipane; Hemant P Sharma; Aziz Sheikh; Timothy L Smith; Pongsakorn Tantilipikorn; Jody R Tversky; Maria C Veling; De Yun Wang; Marit Westman; Magnus Wickman; Mark Zacharek Journal: Int Forum Allergy Rhinol Date: 2018-02 Impact factor: 3.858