Flunisolide—a new intranasal steroid for the treatment of allergic rhinitis

Abstract

Summary A double‐blind, cross‐over comparison of flunisolide nasal spray and its inactive aqueous vehicle has been carried out in fifty patients suffering from perennial allergic rhinitis. Patients were randomly allocated to two groups; the first group (group I) received flunisolide for 3 weeks and then placebo for 3 weeks while the regimes were given in the reverse order to the second group (group II). Patients used two insufflations of 0.1 ml in each nostril twice daily. As the active spray was presented as a 0.025% solution of flunisolide, the total daily dosage was 200 μg. Patients were assessed on admission and at the end of each 3 week period. The results show flunisolide to be significantly superior to placebo in relieving sneezing, nasal obstruction and postnasal drip, as well as improving the quality of sleep and everyday life. At the end of the trial the preferences for treatment recorded by both doctors and patients were significantly in favour of the flunisolide spray. Side effects were minor and occurred during both placebo and active phases of the trial. A short Synacthen test performed at each visit showed no evidence of adrenal suppression.

Effect of Intranasal Corticosteroids on Secondary Sinonasal Symptoms: A Systematic Review of Randomized Trials

“…In total, 9 applicable articles were identified: 8 aqueous studies [12][13][14][15][16][17][18]20 and 1 nonaqueous study. 19 The symptoms evaluated were PND, [12][13][14][15][16] facial pain/pressure/headache, 17,18 and cough. 19,20 Data from an itemized assessment of the risk of bias for the 9 studies are presented in Figure 2.…”

“…13 In 7 studies, "unclear risk of bias" was identified across the domains of blinding of outcome assessment (5 studies), [13][14][15]19,20 blinding of participants and personnel (5 studies), [13][14][15]19,20 random sequence generation (4 studies), 12,14,19,20 allocation concealment (3 studies), 12,14,20 and incomplete outcome data (3 studies). 13,14,17 A "low risk of bias" was found for at least 1 domain in each of the included studies. [12][13][14][15][16][17][18][19][20] PND was a discrete outcome measure in 5 studies (Table 2).…”

“…The association between symptoms of interest and treatment with nasal steroid sprays was evaluated across all studies. [12][13][14][15][16][17][18][19][20]…”

Corticosteroid Aerosols in the Treatment of Asthma

“…Clinical investigators have reported effective results of flunisolide aerosol for asthma in both blinded and open studies of adults and children. [59][60][61][62][63][64] In three separate double-blind trials conducted in adults with chronic asthma, flunisolide aerosol ranging from 0.8-2 mg daily applied in 2 separate doses was compared with placebo for 3 weeks to over 1 year. The investigators found statistically significant differences in favor of flunisolide in major therapeutic responses: improvement in spirometric function and daily symptom scores, reduction or elimination of oral steroids and reduction of nonsteroidal asthma medications.62-64 Some patients developed oral candidiasis when flunisolide was used for over a year, but there were no major adverse clinical reactions or laboratory abnormalities.…”

In vitro effect of beclomethasone dipropionate and flunisolide on the mobility of human nasal cilia

“…Investigations have shown a beneficial clinical effect of both BPD (10,12,13,14) and flunisolide (3,18,24,28), and several comparative studies have concluded that the drugs are equally effective (1,10,25,26).…”