fluticasone-furoate and Conjunctivitis--Allergic

Allergic rhinitis (AR) is a highly prevalent disorder, which often manifests as both nasal (congestion, sneezing, itching and rhinorrhoea) and ocular (redness, watery eyes, itching and burning) symptoms. Until recently, efficacy against the ocular symptoms of AR has been inconsistent for any single intranasal corticosteroid (INS). Fluticasone furoate is an enhanced-affinity glucocorticoid with potent anti-inflammatory activity.. To assess better the efficacy of an INS in the treatment of both the nasal and ocular symptoms of seasonal AR (SAR).. Data from all four trials of fluticasone furoate nasal spray (FFNS) in the treatment of SAR are reviewed and critically considered.. FFNS consistently and significantly improved the nasal and ocular symptoms of SAR in patients sensitised to several different seasonal allergens (grass, ragweed and mountain cedar pollen) in all trials. An integrated analysis of the results also confirmed improvements in both nasal and ocular symptom scores in previously under-represented adolescent patients treated with FFNS.. FFNS is the first INS to show consistent nasal and ocular efficacy across all SAR trials.

Topics: Administration, Intranasal; Adolescent; Androstadienes; Anti-Allergic Agents; Conjunctivitis, Allergic; Humans; Randomized Controlled Trials as Topic; Rhinitis, Allergic, Seasonal

The mechanisms underlying conjunctival symptom reduction by nasal corticosteroids in allergic rhinoconjunctivitis are unknown. A naso-ocular reflex may be present.. To study the effects of nasal fluticasone furoate (FF) on conjunctival symptoms and substance P and histamine levels in tear fluid after nasal grass pollen provocation (GPP).. A double-blind placebo-controlled study was performed in 26 grass pollen-allergic patients. A selective GPP was performed during the grass pollen season after 2 weeks of FF or placebo treatment. Nasal and conjunctival symptoms were scored using a visual analog scale (VAS), and tear fluid was collected for measuring substance P and histamine using an enzyme-linked immunosorbent assay.. Compared with placebo, FF reduced conjunctival symptom scores during the pollen season (-1.75 [-2.75, 0.20] vs 0.0 [0.0, 0.0]; P = .01) and after GPP at 15 minutes (0.05 [-0.42, 1.52] vs 2.05 [0.62, 3.62]; P < .001) and 1 hour (-0.45 [-1.75, 0.1] vs 0.05 [-0.97, 1.85]; P < .01). Treatment with FF decreased substance P levels in tear fluid (44.11 [32.81, 61.02] vs 65.26 [48.62, 79.73] pg/mg protein; P = .0098). Histamine levels in tear fluid showed a GPP-induced increase in the placebo group (7.26 [3.12, 9.69] vs 5.71 [2.05, 7.00] ng/mg protein; P = .02), but not in the FF group (6.77 [3.43, 13.00] vs 5.24 [3.18, 7.06] ng/mg protein; P = .08).. FF nasal spray reduced conjunctival symptoms in grass pollen-allergic patients in parallel with lower substance P levels in tear fluid. These data help in understanding the reduction of conjunctival symptoms by intranasal anti-inflammatory therapy.

Topics: Administration, Intranasal; Adrenal Cortex Hormones; Adult; Androstadienes; Antigens, Plant; Conjunctiva; Conjunctivitis, Allergic; Female; Histamine; Humans; Male; Nasal Provocation Tests; Paranasal Sinuses; Poaceae; Pollen; Rhinitis, Allergic, Seasonal; Seasons; Substance P; Tears; Young Adult

Topics: Administration, Intranasal; Androstadienes; Anti-Allergic Agents; Conjunctivitis, Allergic; Humans; Nasal Sprays; Rhinitis, Allergic, Seasonal

Topics: Administration, Intranasal; Adrenal Cortex Hormones; Androstadienes; Conjunctivitis, Allergic; Controlled Clinical Trials as Topic; Evidence-Based Medicine; Humans; Rhinitis, Allergic, Seasonal; Triamcinolone Acetonide