Once- versus Twice-Daily Fluticasone Propionate Aqueous Nasal Spray for Seasonal Allergic Rhinitis

Abstract

A new potent topical corticosteroid, fluticasone propionate aqueous nasal spray, has proved effective when administered twice daily for seasonal allergic rhinitis. The purpose of this study was to compare the efficacy and safety of a once-daily dosage with twice-daily administration of fluticasone propionate. A multicenter, double-blind, randomized, placebo-controlled study was conducted in adults with moderate to severe symptoms of allergic rhinitis during the autumn pollen season. Patients were treated for 4 weeks with fluticasone propionate aqueous nasal spray, 200 μg once daily or 100 μg twice daily or matching placebo. Fluticasone propionate administered once daily in the morning was as effective as the twice-daily dosage regimen, and both regimens were more effective than placebo. Nasal symptoms were improved by the second day of treatment and continued to improve throughout the study. Nasal eosinophils were reduced in more patients treated with either regimen of fluticasone propionate compared with placebo. Adverse events were similar in frequency and nature in all three groups. There was no evidence of hypothalamicpituitary-adrenal axis effects; mean morning plasma cortisol concentrations and response to cosyntropin stimulation remained within normal ranges and were similar across groups. We conclude that fluticasone propionate aqueous nasal spray administered once daily is safe and as effective as a twice-daily dosage regimen for treating seasonal allergic rhinitis.