Dose‐related efficacy and tolerability of fluticasone propionate nasal drops 400 μg once daily and twice daily in the treatment of bilateral nasal polyposis: a placebo‐controlled randomized study in adult patients

Penttilä, Matti; Poulsen, Peter Bo; Hollingworth, Kate; Holmström, Mats

doi:10.1046/j.1365-2222.2000.00695.x

Cited by 102 publications

(114 citation statements)

References 31 publications

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“…Other studies in patients with severe or bilateral polyposis found evidence of similar efficacy and tolerability of fluticasone propionate or beclomethasone dipropionate, with some evidence that fluticasone had a more rapid onset of action. [100][101][102] However, these reports lack the kinds of sizable effects that can be translated into practical application in a clinical setting. 103 The largest of these studies included fewer than 150 patients, with most enrolling fewer than 100 individuals, and the longest study was of only six months' duration.…”

Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 99%

“…[102][103][104][105][106][107] In 183 patients with moderate-sized nasal polyps causing clinically significant symptoms, budesonide aqueous nasal spray at a dose of 128 µg once or twice daily, or 256 µg once daily for eight weeks significantly reduced polyp size (p<0.01) and improved peak nasal inspiratory flow (p<0.001) compared with placebo. 106 Combined and individual symptom scores (blocked nose, runny nose, and sneezing) and sense of smell also improved significantly in all budesonide-treated groups.…”

Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 99%

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Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems.In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators -and therefore nasal congestion and other symptoms -should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

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Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 99%

Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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“…They are effective in decreasing the size of polyps [8,9] and in inhibiting eosinophil infiltration into polyp tissue [10], but their effect on mucin production is not established.…”

mentioning

confidence: 99%

Intranasal steroids decrease eosinophils but not mucin expression in nasal polyps

Burgel

Cardell²,

If³

et al. 2004

Eur Respir J

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Increased mucin expression is a feature of nasal polyposis. Corticosteroids reduce polyp size and symptoms, but their effect on mucin production remains unknown. In this study, the effects of intranasal corticosteroids on MUC5AC mucin expression, nasal resistance, eosinophil and neutrophil infiltration, epidermal growth factor receptor (EGFR), interleukin (IL)-8, and tumour necrosis factor (TNF)-a expression was assessed in nasal polyps.In nine subjects, one nasal polyp was removed surgically before treatment and another was removed after 8 weeks of intranasal fluticasone (400 mg?day -1 ). Tissues were processed for in situ hybridisation and immunohistochemical staining. Described effects of fluticasone on nasal polyps (reduction in nasal resistance and in eosinophil infiltration) were evaluated. Morphometric analysis was performed to assess the effect of fluticasone on epithelial-, MUC5AC-, EGFR-and IL-8-stained areas, TNF-astained cells, and neutrophil numbers.Treatment with fluticasone decreased nasal resistance and intra-epithelial eosinophils. The MUC5AC-stained area in the epithelium was unchanged by treatment; MUC5AC mRNA expression was unaffected by treatment. EGFR-stained area, intraepithelial neutrophil numbers, IL-8 and TNF-a expression were also unchanged by therapy.Intranasal fluticasone was effective in decreasing nasal airflow resistance and intraepithelial eosinophils but had no effect on mucin or epidermal growth factor receptor expression or on neutrophil recruitment.

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“…A first step of management is medical treatment with intranasal and, if necessary, additive treatment with oral corticosteroids [3]. It is documented that administration with fluticasone propionate nasal drops (FPND) can decrease polyp size and nasal congestion [4,5]. Although it has been suggested that the effects of nasal polypectomy and functional endoscopic sinus surgery (FESS) on lower airways in NP is not conclusive [3], we recently reported reduced upper as well as lower airway symptoms and improvement in clinical parameters (PNIF, olfactory thresholds, PEFR) after FESS.…”

Section: Introductionmentioning

confidence: 99%

“…The GWBS is a generic instrument for assessing psychological wellbeing and distress, with the underlying dimensions anxiety, depression, general health, positive well-being, self-control and vitality [10,11]. Considering the suggested improvement in nasal symptoms after FPND [5] and improvement in airway symptoms and clinical parameters after FESS [6], it was hypothesized (i) that administration with 400 µg b.i.d. of …”

Section: Introductionmentioning

confidence: 99%

Effects of FESS and additional fluticasone propionate nasal drops on psychological well-being in nasal polyposis with asthma

Nordin

Olsson²,

Blomqvist³

et al. 2013

Acta Oto-Laryngologica

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Conclusion: A combined therapy of fluticasone propionate nasal drops (FPND) and functional endoscopic sinus surgery (FESS) can improve quality of life (QoL). When compared with prior data, the results imply that a generic measure of psychological aspects of QoL may be better than measures of respiratory symptoms and clinical parameters to capture a patient's perception of the disease and its treatment.Objective: To better understand effects of FPND and FESS on generic QoL. Methods:Sixty nasal polyposis patients with concomitant asthma completed participation in a randomized, double-blind, placebo-controlled, 14-week study in which they responded to the General Well-Being Schedule (GWBS).Results: GWBS scores (i) increased significantly after administration of FPND, independent of FESS (from lower than normal to normal), (ii) increased after FESS independent of FPND (from lower than normal to normal), and (iii) increased additively after FPND and FESS.

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Dose‐related efficacy and tolerability of fluticasone propionate nasal drops 400 μg once daily and twice daily in the treatment of bilateral nasal polyposis: a placebo‐controlled randomized study in adult patients

Abstract: FPND 400 microg once or twice daily is an effective and well-tolerated treatment for bilateral nasal polyposis.

Cited by 102 publications

References 31 publications

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Intranasal steroids decrease eosinophils but not mucin expression in nasal polyps

Effects of FESS and additional fluticasone propionate nasal drops on psychological well-being in nasal polyposis with asthma

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