(9R)-9-chloro-11-17-dihydroxy-17-(2-hydroxy-1-oxoethyl)-10-13-16-trimethyl-6-7-8-11-12-14-15-16-octahydrocyclopenta[a]phenanthren-3-one and Rhinitis--Allergic

Allergic rhinitis (AR) is a common respiratory disease, and its prevalence is increasing all over the world, both in adults and in children. Patients experience symptoms that may negatively impact on physical, social and psychological well-being. Hence, if left untreated, allergic rhinitis may significantly affect quality of life. Under current guidelines, intranasal corticosteroids are considered the most effective drugs and they are recommended as first-line therapy. Among the several corticosteroid intranasal sprays available, beclomethasone dipropionate is one of the most prescribed. Recently, new intranasal hydrofluoroalkane-propelled formulations with little or no impact on the ozone layer have been developed for the treatment of AR. The use of these devices might improve patients' adherence to treatment, avoiding some of the most common side effects associated with aqueous formulations. This review provides the most recent evidence for the efficacy and safety of beclomethasone dipropionate hydrofluoroalkane nasal aerosol in the treatment of allergic rhinitis.

Topics: Adult; Aerosol Propellants; Animals; Anti-Asthmatic Agents; Beclomethasone; Child; Humans; Hydrocarbons, Fluorinated; Medication Adherence; Nasal Sprays; Quality of Life; Rhinitis, Allergic

Allergic rhinitis (AR) is a common chronic disorder, affecting 10 -30% of populations. AR has significant morbidity and expense. AR patients treat themselves with over-the-counter medications. However the usual H1 antihistamines are often inadequate. Intranasal corticosteroids effectively diminish AR symptoms. Beclomethasonedipropionate (BDP) was reported to effectively treat adults and children with AR. BDP was a chlorofluorocarbon (CFC) propellant pressurized metered dose inhaler (pMDI). Subsequently BDP appeared in an aqueous format. Some patients preferred the dryer sensation of pMDI to aqueous formulations. The protocol of Montréal, removed CFC devices from medical practice. The remaining intranasal steroids were in aqueous format. Many patients did not like the sensory perceptions using liquids intranasal. They were unlikely to be compliant. BDP hydrofluoroalkanepMDI (BDP HFA) was developed.. The need of active treatment of AR will be reviewed. Chemistry, pharmacokinetics and pharmacodynamics of BDP HFA will be presented. Clinical efficacy studies and safety data which led to the approval of BDP for use in adults and children will be reviewed.. BDP HFA is an option to treat AR, demonstrating a favorable therapeutic index in large double-blind placebo-controlled studies. BDP HFA appeals to select AR patients.

Topics: Administration, Inhalation; Administration, Intranasal; Beclomethasone; Chronic Disease; Glucocorticoids; Humans; Metered Dose Inhalers; Patient Compliance; Rhinitis, Allergic

Allergic rhinitis is the most frequent allergic disorder, as its prevalence is more than 20% in the general population. Non-allergic rhinitis has similar symptoms, but pathogenic mechanisms are non-IgE-mediated. Anyway, both diseases share a common inflammatory pathway, thus anti-inflammatory drugs represent the optimal therapeutical option. Beclomethasone dipropionate (BDP) is a corticosteroid that is long time available both as intranasal spray and aerosol solution. The present review aims at analysing the most relevant and recent studies concerning the BDP use in allergic and non-allergic rhinitis. The research was performed using Medline and Scopus database, key words were: allergic and non-allergic rhinitis, beclomethasone (last access 31st July 2014). BDP is a corticosteroid with proved efficacy in the treatment of rhinitis, both as spray and aerosol. Safety issue has been satisfactory explored, thus BDP is usually safe and well tolerated.

Topics: Administration, Intranasal; Administration, Topical; Aerosols; Anti-Inflammatory Agents; Beclomethasone; Humans; Rhinitis, Allergic; Rhinitis, Vasomotor

The deposition of nasal aerosols from both aqueous formulations and propellant-based formulations has only minimally been described in rhinitis patients. This study quantified the regional nasal deposition of QNASL(™) (HFA-beclomethasone, nasal aerosol), Flonase(™) (fluticasone propionate, nasal spray) and Nasonex(™) (mometasone furoate monohydrate, nasal spray).. This study was an open label, crossover study in nine patients with allergic rhinitis. The regional nasal deposition of the three nasal products was compared and contrasted following delivery of the (99m)Tc-radiolabeled drug product in each product. The gamma images were merged with magnetic resonance images to quantify regional deposition within the patients.. The HFA propellant-based formulation (QNASL) resulted in an increased retention of drug product in the nasal cavity compared with the two aqueous formulations (Flonase and Nasonex). The aqueous based formulations resulted in increased amount of the delivered dose that dripped from the nostril (6/8 patients for each of the aqueous formulations and 0/8 patients for the HFA propellant formulation) following administration. The percentage of delivered dose that deposited in the back of the throats of the patients was increased and variable (0.1% to 17.6% with Flonase and 0.0 to 4.7% for Nasonex) for the aqueous formulations when compared to dose delivered for the HFA propellant formulation (0.0% to 1.7% for QNASL).. The regional deposition of the HFA propellant based formulation resulted in increased retention of drug product in the nasal cavity and decreased deposition in the back of the throat compared to the two aqueous formulations.

Topics: Adult; Aerosol Propellants; Aerosols; Beclomethasone; Chemistry, Pharmaceutical; Chromatography, High Pressure Liquid; Cross-Over Studies; Fluticasone; Humans; Hydrocarbons, Fluorinated; Middle Aged; Mometasone Furoate; Nasal Mucosa; Rhinitis, Allergic; Tomography, Emission-Computed, Single-Photon

The purpose of this study was to investigate the association between long-term intranasal steroid use and intraocular pressure (IOP) elevation.. In total, 100 eyes from 50 patients on long-term intranasal steroids (>2 y) for allergic rhinitis and 90 eyes from 45 controls were included in this study. Patients on other forms of steroids and risk factors for glaucoma were excluded. IOP was measured and nonmydriatic stereoscopic optic disc photos were taken for each eye. The vertical cup-to-disc ratio and the status of the optic disc were evaluated.. The mean IOP for intranasal steroids group was significantly higher (15.24±2.31 mm Hg) compared to the control group (13.91±1.86 mm Hg; P=0.000). However, there were no significant differences in the vertical cup-to-disc ratio and the status of glaucomatous optic disc changes between the groups.. Prolonged use of intranasal steroids cause statistical significant increase in IOP in patients with allergic rhinitis although no significant glaucomatous disc changes were seen. We suggest patients on long-term use of intranasal steroid have a yearly eye examination to be monitored for IOP elevation and those with additional risk factors for glaucoma is closely monitored for glaucoma.

Topics: Administration, Intranasal; Adolescent; Adult; Androstadienes; Anti-Allergic Agents; Beclomethasone; Child; Cross-Sectional Studies; Female; Glaucoma; Glucocorticoids; Humans; Intraocular Pressure; Male; Mometasone Furoate; Optic Disk; Optic Nerve Diseases; Rhinitis, Allergic; Tonometry, Ocular; Young Adult

Inflammatory rhinitis is a very common disorder. It includes allergic rhinitis (AR) and non-allergic rhinitis (NAR). Nasal inflammation is shared by both disorders. So, anti-inflammatory treatment is indicated for both. Beclomethasone dipropionate (BDP) is a corticosteroid that is long time available both as intranasal spray and aerosol solution. BDP is a corticosteroid with proved efficacy in the treatment of rhinitis, both as spray and aerosol. Safety issue has been satisfactory explored, thus BDP is usually safe and well tolerated. Hyaluronic acid (HA) with high molecular weight has anti-inflammatory activity associated with wetting-lubricating effect. BDP may be usefully employed in acute forms, HA may be also used in chronic ones.

Topics: Administration, Intranasal; Aerosols; Anti-Inflammatory Agents; Beclomethasone; Humans; Hyaluronic Acid; Molecular Weight; Rhinitis, Allergic; Rhinitis, Vasomotor

Topics: Administration, Inhalation; Aminopyridines; Androstadienes; Asthma; Beclomethasone; Benzamides; Cyclopropanes; Humans; Indans; Maleates; Nasal Sprays; Powders; Pulmonary Disease, Chronic Obstructive; Quinolones; Respiratory Tract Diseases; Rhinitis, Allergic

Topics: Administration, Inhalation; Administration, Intranasal; Adrenal Cortex Hormones; Asthma; Beclomethasone; Child; Child Development; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Prospective Studies; Puberty; Rhinitis, Allergic

It's been 40 years since Niels Mygind publication in British Medical Journal on intranasal application of beclomethasonedipropionate aerosol in Allergic Rhinitis. Since then the new era in treatment of allergic and non-allergic upper airway diseases has begun. This publication presents current concepts on application of intranasal glucocorticosteroids in treatment of upper airway diseases and in particular of allergic rhinitis and rhinosinusitis. The non-questionable advantage of intranasal glucocorticosteroids is their strong anti-inflammatory local action with little impact on general health responsible for few and benign side effects. Main way of action of glucocorticosteroids is connected with binding to the intracellular glucocorticosteroid receptor and its impact on nuclear cytoplasmic transcriptional factors. Glucocorticosteroids suppress gene expression of factors responsible for generating and supporting inflammatory processes, pro-inflammatory cytokines and chemokines production, adhesive molecules expression. It appears that glucocorticosteroids has also other mechanisms of action, non-involving intracellular receptors, leading to inhibiting of early and late phase of allergic reaction. At the moment there are following glucocorticosteroids registered in Poland: beclomethasone, budesonide, fluticasone propionate, fluticasone fuorate, mometasonefuorate. Special attention earns fuorates as their lateral fuorate ester chain makes this molecules highly lipophilic, easily absorbed by nasal mucous membranes epithelium and cell membranes phospholipids. This minimizes their general action and maximizes local action. According to current state of knowledge topical glucocorticosteroids are used in the following upper airway diseases with different inflammatory mechanism: allergic rhinitis, non-allergic rhinitis, particularly NARES, acute rhinosinusitis, chronic rhinosinusitis with and without nasal polyps, adenoid hypertrophy and rhinitis in bronchial asthma.

Topics: Administration, Intranasal; Androstadienes; Beclomethasone; Child; Female; Fluocinolone Acetonide; Glucocorticoids; Humans; Male; Mometasone Furoate; Nasal Mucosa; Patient Safety; Poland; Rhinitis, Allergic

Allergic rhinitis (AR) is one of the most common chronic respiratory diseases observed in the pediatric population, producing a significant morbidity, and an economic burden due to direct medical costs and indirect costs. Despite the high prevalence of AR in children and the importance of the use of topical intranasal corticosteroids for its treatment, comparative analyses of alternative treatments in pediatric patients, in terms of both cost and effectiveness are lacking.. A decision-analysis model was developed to estimate the cost-effectiveness of mometasone furoate nasal spray (MFNS) compared to beclomethasone dipropionate nasal spray (BDNS) for treating pediatric patients with AR over a 12-month period. Effectiveness parameters were obtained from a published study in which authors performed a systematic review of the literature. Cost data were obtained from a hospital's bills and from the national manual of drug prices. The study assumed the perspective of the national healthcare in Colombia. The outcomes were three effectiveness measures summarized in a therapeutic index (TIX).. For the base-case analysis, the model showed that compared to BDNS, therapy with MFNS was associated with lower costs (US$229.78 vs. 289.74 average cost per patient over 12 months) and a greater improvement in TIX score (0.9724 vs. 0.8712 score points on average per patient over 12 months), thus leading to dominance.. The present analysis shows that in Colombia, compared with BDNS, therapy with MFNS for treating pediatric patients with AR is a dominant strategy because it showed a greater improvement in a TIX reflecting both efficacy and safety, at lower total treatment costs.

Topics: Administration, Intranasal; Anti-Asthmatic Agents; Beclomethasone; Child; Colombia; Cost-Benefit Analysis; Female; Humans; Models, Econometric; Mometasone Furoate; Rhinitis, Allergic