Once-daily mometasone furoate nasal spray: efficacy and safety of a new intranasal glucocorticoid for allergic rhinitis.

Once-daily mometasone furoate nasal spray (MFNS) is a new intranasal glucocorticoid for the treatment of seasonal allergic rhinitis and perennial rhinitis, and for the prophylaxis of seasonal allergic rhinitis. This paper reviews key findings from the clinical development program for MFNS, comprising more than 20 clinical trials with more than 6000 patients worldwide. MFNS exhibits strong anti-inflammatory activity in vitro and in vivo, and has a rapid onset of action, affording clinically significant symptom relief in 28% of patients within 12 hours of the first dose. Once-daily MFNS is at least as effective as other intranasal glucocorticoids, including twice-daily beclomethasone dipropionate and once-daily fluticasone propionate and budesonide. MFNS is well tolerated and has no detectable effect on the hypothalamic-pituitary-adrenal axis, even at up to 20 times the recommended daily dose. MFNS does not cause atrophy of the nasal mucosa; in fact, prolonged treatment tends to restore the nasal mucosa to a more normal phenotype. The once-daily dosing schedule of MFNS may improve patient compliance, while its high margin of systemic safety and rapid onset of action may enhance patient and physician acceptance.