Efficacy and safety of mometasone furoate nasal spray in nasal polyposis

Small, Catherine B.; Hernandez, Jaime; Reyes, A.; Schenkel, Eric; Damiano, Angela; Stryszak, Paul; Staudinger, Heribert; Danzig, Melvyn R.

doi:10.1016/j.jaci.2005.07.027

Cited by 139 publications

(177 citation statements)

References 23 publications

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“…Significant improvements were also seen in the secondary endpoints of anterior rhinorrhea, postnasal drip, and loss of smell. 96 These results were confirmed in a similarly designed 4-month trial in 310…”

Section: Acute Rhinosinusitis and Nasal Polyposis: Association With Amentioning

confidence: 73%

“…Intranasal corticosteroids may partially prevent recurrence of polyps, thus potentially reducing or delaying the need for treatment. 92,96 Intranasal surgery traditionally has been the most common approach to treatment of nasal polyps. However, evidencebased guidelines published in a recent European Academy of Allergology and Clinical Immunology (EAACI) position paper recommend the use of INS as first-line treatment for nasal polyposis.…”

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: 73%

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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“…This is probably because of its inherently low aqueous solubility, which allows only a small fraction of the drug to cross the nasal mucosa and enter the bloodstream, and because a large amount of the administered drug is swallowed and undergoes extensive first-pass metabolism (22). There is no clinical evidence that MFNS suppresses the function of the hypothalamic-pituitary-adrenal axis when the drug is administered at clinically relevant doses (100-400 lg/day) (14,23). Furthermore, its safety and tolerability have been assessed in clinical trials involving approximately 4500 patients, with epistaxis, headache and pharyngitis being the most common adverse effects (22).…”

Section: Discussionmentioning

confidence: 99%

“…Mometasone furoate, a potent, topically active, synthetic, 17-heterocyclic corticosteroid was originally introduced for the treatment of dermatological conditions (12). Subsequently, mometasone furoate aqueous nasal spray (MFNS) (Nasonex; Schering-Plough, Inc., Kenilworth, NJ, USA) was shown to be effective in several inflammatory conditions of the upper respiratory tract, including AR (4) and non-AR (12), nasal polyps (13,14), adenoidal hypertrophy (15) and uncomplicated rhinosinusitis (16).…”

mentioning

confidence: 99%

“…There is no clinical evidence that MFNS suppresses the function of the hypothalamic-pituitary-adrenal axis when the drug is administered at clinically relevant doses (100-400 lg/day) (14,23), and there are no reports of any influence on childrenÕs growth (24)(25)(26). Finally, histological studies after long-term use of MFNS have shown no signs of atrophy of the nasal mucosa (27).…”

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confidence: 99%

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Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Penagos

Compalati

Tarantini

et al. 2008

Allergy

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Rationale: Several randomized, double‐blind, placebo‐controlled clinical trials have demonstrated the efficacy of mometasone furoate nasal spray (MFNS) in the treatment of allergic rhinitis (AR) thus allowing for a meta‐analysis to determine the overall treatment effect.Methods: A comprehensive search of the MEDLINE, LILACS, SCOPUS, and the Cochrane Library databases up to 31 October, 2007 was carried out. Randomized, double‐blind, placebo‐controlled, clinical trials evaluating the efficacy of MFNS in patients with AR compared to placebo were included. Total nasal symptom scores (TNSS), individual nasal symptoms, total non‐nasal symptom scores (TNNSS) and nasal airflow were analysed as the standardized mean difference (SMD). Meta‐analysis was performed with the random or the fixed effect models depending on heterogeneity, by using revman 5 software.Data synthesis: Sixteen of the 113 identified articles met the inclusion criteria. For MFNS efficacy on TNSS, 2998 participants were analysed: 1534 received MFNS and 1464 placebo. Mometasone furoate nasal spray was associated with a significant reduction in TNSS (SMD −0.49, 95% CI: −0.60 to −0.38; P < 0.00001; I2 = 50.1%). A significant effect on SMD for nasal stuffiness/congestion (−0.41; 95% CI: −0.56 to −0.27), rhinorrhoea (−0.44; 95% CI: −0.66 to −0.21), sneezing (−0.40; 95% CI: −0.57 to −0.23) and nasal itching (−0.39; 95% CI: −0.53 to −0.25) was also demonstrated. Mometasone furoate nasal spray treated subjects also showed a significant reduction in TNNSS (−0.30; 95% CI: −0.43 to −0.18). The proportion of patients with adverse events was similar for MFNS and placebo (0.99; 95% CI: 0.81–1.20; P = 0.91).Conclusions: This meta‐analysis provides a level Ia evidence for the efficacy of MFSN in the treatment of AR vs placebo. Adverse events frequency was similar in both groups.

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