mometasone-furoate and Nasal-Obstruction

To study and review the short- and long-term effects of intranasal steroids on obstructive adenoids.. In this prospective cohort study, 19 children previously treated with mometasone furoate for 3 months were contacted at 3, 6 and 12 months after cessation of treatment. Main outcome measures included: change in severity of nasal obstruction, allergic rhinitis and obstructive symptoms. A systematic review of literature was also performed.. By one year, 25 per cent of patients required adenoidectomy; the remaining children had no significant change in clinical score (p = 0.464), obstruction severity (p = 0.191) or allergic symptoms (p = 0.284). Fourteen pertinent studies were identified; all but one study showed improvement in the patients' symptoms and/or degree of obstruction. Two studies with follow up reaching 25 months showed positive effects.. The short-term positive effect of some intranasal steroids on obstructive adenoids seems to persist in a significant number of patients after the cessation of treatment.

Topics: Adenoidectomy; Adenoids; Administration, Intranasal; Administration, Topical; Anti-Inflammatory Agents; Child; Child, Preschool; Female; Humans; Male; Mometasone Furoate; Nasal Obstruction; Prospective Studies; Rhinitis, Allergic; Severity of Illness Index; Time

Mometasone has been reported to improve the symptoms of nasal obstruction in children with adenoidal hypertrophy. This systematic review and meta-analysis were conducted to evaluate the role of mometasone on different nasal symptoms, otitis media with effusion, adenoid size, and quality of life in children with adenoidal hypertrophy.. A comprehensive search of MEDLINE, EMBASE, CINAHL and COCHRANE Collaboration databases was undertaken. We identified all the randomized controlled trials (RCTs) in children with adenoidal hypertrophy that compared the effects of mometasone nasal spray and normal saline nasal spray on different outcomes. The deadline of the search was April 2015. The search was supplemented by hand searching of cross-references in the studies and reviews and by contacting the authors of various studies. Only English language RCTs were considered for the systematic review. The primary outcomes were improvement in symptoms of nasal obstruction, mouth breathing, rhinorrhea, snoring, cough, and total nasal symptoms. The secondary outcomes were improvement in otitis media with effusion, quality of life, and size of adenoid. Quality assessment of RCTs was performed using SIGN 50 and Cochrane risk of bias tools. Risk ratio (RR), weighted mean differences (WMD) and their 95% confidence intervals (CI) were calculated for dichotomous and continuous data, respectively. Random effects model was used for the analyses. Heterogeneity was measured by using the I(2) statistics and p value <0.05.. Our search generated 87 citations, of which eight RCTs met the inclusion criteria. The methodological quality of all the RCTs was poor. There was no significant difference between mometasone and control groups for the patient's characteristic and grades of different nasal symptoms, otitis media with effusion, obstructive sleep apnea, and quality of life at the basal level. There was also no significant difference in the number of patients with different symptoms at the basal level. After the administration of mometasone, there were significant improvements in grades of nasal obstruction, 0.8±0.5 versus 2.0±0.6, WMD -1.16 [-2.09, -0.23], snoring 0.3±0.4 versus 1.6±0.6, WMD -1.07 [-2.09, -0.05], total nasal symptoms 2.9±1.3 versus 6.9±1.5, WMD -4.09 [-6.64, -1.53], obstructive sleep apnea, 0.6±0.3 versus 1.4±0.4, WMD -0.95 [-1.74, -0.16], as well as the percentage of patients with nasal obstruction, snoring, obstructive sleep apnea, compared to control. There was tendency of improvement in rhinorrhea, and cough with mometasone. Compared to control, mometasone nasal spray significantly improved adenoid size or adenoid/choana ratio 50.9±8.8 versus 74.2±12.6, WMD -21.2 [-34.0, -8.4], change in adenoid/choana obstruction from the basal level (p=0.01), and percentage of patients with adenoid hypertrophy, 26% versus 92%, RR 0.29 [0.18, 0.48]. There was improvement in otitis media with effusion, 40% versus 72%, pure tone audiometry 5.2±11 versus 11.6±11dB, WMD -6.40dB [-12.65, -0.15], and quality of life with mometasone. Subgroup analyses showed that RCTs that followed blinding showed significantly less response compared to RCTs that did not follow it for most of the outcomes.. Mometasone caused improvements in outcomes of nasal obstruction, snoring, total nasal symptoms, pure tune audiometry, otitis media with effusion, adenoid size, and quality of life. The data is based on meta-analysis of RCTs of poor methodological quality. A high methodological quality, placebo controlled RCT of different doses and duration of administration of mometasone is required to evaluate its clear efficacy and safety in children with adenoid hypertrophy.

Topics: Adenoids; Anti-Inflammatory Agents; Child; Child, Preschool; Humans; Hypertrophy; Mometasone Furoate; Nasal Obstruction; Quality of Life; Treatment Outcome

Nasal obstruction is the symptom par excellence signalling the onset of nasal-sinus inflammatory pathologies (allergic rhinitis, acute or intermittent rhinosinusitis without nasal polyps, persistent rhinosinusitis without nasal polyps, chronic or intermittent rhinosinusitis associated with nasal-sinus polyposis). This symptom is due, in particular, to the host's response to the etiological factor for which, where there is no accompanying infectious process, the therapy should be aimed at resolving the inflammatory response. The anti-inflammatory properties of steroid drugs have been used systemically with excellent results. Unfortunately, prolonged use can foster the onset of major side-effects. Hence, the need to create new pharmacological molecules with topical action, while maintaining the characteristics of systemically used steroids. Up to the present, many intranasal steroids have been examined with positive results in inflammatory nasal-sinus pathologies. It should be noted that systemic bioavailability after intranasal therapy with mometasone furoate (MF) is lowest with respect to other steroid molecules. In recent decades topical intranasal steroids have also been tested in adenoid hypertrophy, a typical infant condition, with encouraging results. For this reason, the authors have assessed the effectiveness of MF on the reduction of the adenoid mass and, consequently, on the improvement in obstructive nasal symptoms in the short term and after a long-term follow-up, obtaining positive results. To conclude, intranasal steroid drugs are certainly useful in the treatment of nasal-sinus inflammatory pathologies. Furthermore, our studies have shown that MF can improve the clinical picture of adenoid hypertrophy.

Topics: Administration, Intranasal; Anti-Allergic Agents; Anti-Inflammatory Agents; Child; Controlled Clinical Trials as Topic; Drug Therapy, Combination; Glucocorticoids; Humans; Meta-Analysis as Topic; Mometasone Furoate; Nasal Obstruction; Nasal Polyps; Practice Guidelines as Topic; Pregnadienediols; Randomized Controlled Trials as Topic; Rhinitis; Sinusitis; Treatment Outcome

Background/aim: The incidence of adenoid hypertrophy is 2%-3% in children. Adenoidectomy is a commonly performed procedure in children that may cause complications such as early or late bleeding (4%-5%), recurrence of adenoid tissue (10%-20%), and postoperative respiratory problems (27%). Therefore, medical therapy alternatives to adenoidectomy are important and must be tried before surgery. In this study, we investigated the efficacy of mometasone furoate, montelukast, and a combination of these drugs in pediatric patients with adenoid hypertrophy who were scheduled for reduction with medical therapy after not being recommended for surgery.Materials and methods: The study included 120 children with adenoid hypertrophy aged between 4 and 10 years. The patients were randomized into 4 separate groups, with 30 in each group. Group 1 received 100 μg of mometasone furoate per day, group 2 received 4/5 mg (for age) montelukast per day, and group 3 received mometasone furoate + montelukast. Medical therapy continued for 3 months in the treatment groups. Group 4, which comprised patients with mild symptoms, received no treatment and was the control group. The pre- and posttreatment adenoid tissue ratios in lateral neck radiographs were recorded in the four groups. Results: When radiologic measurements of adenoid-to-air passage were calculated, an improvement of 21.76% was observed in group 1 after treatment. The rate of improvement was 22.51% in group 2. There was a 21.79% reduction in adenoid size in group 3 after 3 months? treatment and 12.46% in the control group. There were statistically significant differences between pre- and posttreatment values in every single group administered corticosteroids, montelukast, and combined therapy (P < 0.05).Conclusion: According to our results, both montelukast and mometasone furoate therapies were similarly successful in treating adenoid hypertrophy. Combined therapy has no superiority over single-therapy treatment.

Topics: Acetates; Adenoids; Administration, Intranasal; Adrenal Cortex Hormones; Anti-Inflammatory Agents; Child; Child, Preschool; Cyclopropanes; Drug Therapy, Combination; Female; Humans; Hypertrophy; Male; Mometasone Furoate; Nasal Obstruction; Prospective Studies; Quinolines; Recurrence; Sulfides; Treatment Outcome

One of the most frequent reasons of nasal obstruction and sleep apnea in pediatrics is adenoid hypertrophy. Remaining adenoid tissue can reoccur following hypertrophied adenoid removal and a second operation may be needed. Nasal corticosteroids are utilized in order to reduce adenoid hypertrophy and eliminate adenoidectomy operation. The purpose of our study is to assess the effect of nasal corticosteroid administration after adenoidectomy on adenoid regrowth and symptom scores.. Seventy patients who had adenoidectomy were enrolled in our study. Patients were divided into two groups. Group I (35 patients) received Mometasone furoate (40mcg/day per nostril) intranasal spray for 6 months, starting at postoperative week 3 after wound healing. As for Group II (35 patients), they received intranasal saline spray. Patients were followed up for one year. Every patient had flexible nasal endoscopy at postoperative week 3 and one year after the operation. Choana was scored according to its occlusion level by the adenoid tissue. Additionally, nasal obstruction symptoms (nasal congestion, dry mouth, snoring, nasal speaking, apnea and night coughing) were scored.. Remaining adenoid tissue in the nasopharynx was comparable in flexible endoscopic assessment and no significant difference was seen between postoperative week 3 nasal obstruction scores. In the flexible endoscopic assessment completed in the twelfth month of the study, significant reduction was found in Group 1 compared to Group 2 in terms of adenoid size. When patients in both groups were compared, statistically significant reduction was observed in nasal obstruction symptom scores at the twelfth month.. This study has demonstrated that the use of steroid nasal spray following adenoidectomy significantly prevents regrowth and reduces nasal obstruction symptoms in the early period.

Topics: Adenoidectomy; Adenoids; Administration, Intranasal; Child; Child, Preschool; Cross-Sectional Studies; Female; Glucocorticoids; Humans; Hypertrophy; Infant; Male; Mometasone Furoate; Nasal Obstruction; Nasal Sprays; Postoperative Care; Recurrence; Sodium Chloride

To study the role of mometasone furoate aqueous nasal spray for the management of adenoidal hypertrophy in children with more than 50 per cent obstruction, and to assess its impact on change in quality of life.. A prospective, randomised, double-blind, interventional placebo-controlled study was conducted. A total of 100 children aged 2-12 years completed treatment and follow up. The symptoms and degree of obstruction were evaluated by nasopharyngoscopy conducted pre-treatment and 24 weeks post-treatment. Subjects received mometasone furoate nasal spray at a daily dose of 200 µg for 8 weeks, followed by a dose of 200 µg on alternate days for 16 weeks. RESULTS were compared with those of a matched control group who were given saline nasal spray.. With mometasone treatment, there was an 89.8 per cent reduction in clinical symptom score, and the degree of obstruction dropped from 87 to 72 per cent (p < 0.0001). A statistically significant change in quality of life scores was seen in patients treated with the mometasone nasal spray (score change of 37.47) as compared with those given saline nasal spray (score change of 11.25) (p = 0.0001).. Mometasone nasal spray appears to be effective in treating children with obstructive adenoids.

Topics: Adenoids; Anti-Inflammatory Agents; Child; Child, Preschool; Double-Blind Method; Female; Humans; Hypertrophy; Male; Mometasone Furoate; Nasal Obstruction; Nasal Sprays; Pregnadienediols; Prospective Studies; Quality of Life; Sodium Chloride; Treatment Outcome

This study aimed to compare the effectiveness of radiofrequency ablation (RFA) and intranasal steroid (INS) treatments on respiratory and olfactory functions in patients with inferior concha hypertrophy and chronic nasal obstruction.. This was a prospective clinical trial performed at a tertiary referral center.. We assessed patients with nasal obstruction between July 2011 and February 2012. The severity of the nasal obstruction in both groups was determined before treatment and 3 months after using a visual analog scale. For the purpose of an objective test, assessment was performed by the acoustic rhinometry. Using Sniffin' Sticks for test odor identification, the discrimination and thresholds were assessed in both groups.. The visual analog scale score after treatment was significantly lower in each group. Radiofrequency ablation treatment significantly improved the right minimal cross-sectional area 1 (MCA1), mean MCA1, and volume 1, as well as the right MCA2, mean MCA2, volume 2, and total volume. In the INS group, improvement was detected for the left MCA1, mean MCA1, and volume 1. Minimal cross-sectional area 2, volume 2, and total volume improved significantly after RFA treatment, but not after INS treatment.. Although RFA may be more effective in the posterior region of the nasal cavity, INS and RFA used in the treatment of inferior concha hypertrophy both had favorable effects on respiratory function. Intranasal steroid treatment provided improved discrimination and total score values, whereas RFA treatment improved only odor identification.

Topics: Administration, Intranasal; Adult; Anatomy, Cross-Sectional; Anti-Inflammatory Agents; Catheter Ablation; Female; Follow-Up Studies; Humans; Hypertrophy; Male; Mometasone Furoate; Nasal Cartilages; Nasal Cavity; Nasal Obstruction; Odorants; Pregnadienediols; Prospective Studies; Respiration; Rhinometry, Acoustic; Sensory Thresholds; Smell; Treatment Outcome

This study aimed at observing the efficacy of mometasone fuorate monohydrate nasal spray on obstructive adenoids in children and identifying the characteristics of responders using a pilot study including children aged 2-11 years, with evidence of more than 50 % obstruction. Allergic rhinitis and nasal obstruction were evaluated on baseline (V0), 6- (V1), and 12-week (V2) visits. Degree of obstruction was evaluated by nasopharyngoscopy at V0 and V2. Subjects received 100 μg mometasone fuorate daily. Results were compared with those of a matching control group. Nineteen children (8 females, 11 males; 2.25-8.50 years old, mean 4.24 years, median 4.00 years) completed treatment and follow-up adequately. There was 58 % reduction in a clinical score assessing the severity of adenoidal obstruction (P < 0.05), 56 % reduction in severity of obstructive symptom (P < 0.05), and 75 % reduction in allergic rhinitis score (P < 0.05) between V0 and V1. No further significant improvement was noticed between V1 and V2. The degree of obstruction dropped from 85 to 61 % as noted on endoscopy (P < 0.05). None in the control group showed spontaneous decrease or resolution of the symptoms. Age of patients, allergic rhinitis score, and severity of the clinical score had no impact on the response parameters. No side effects were observed. Mometasone furoate monohydrate nasal spray appears to be effective in treating children with obstructive adenoids. The effect seems to be independent of the presence of mild intermittent allergic rhinitis, the age of patient, or the severity of symptoms.

Topics: Adenoids; Anti-Inflammatory Agents; Child; Child, Preschool; Endoscopy; Female; Humans; Hypertrophy; Male; Mometasone Furoate; Nasal Obstruction; Pilot Projects; Pregnadienediols; Rhinitis, Allergic; Rhinitis, Allergic, Perennial; Treatment Outcome

Intranasal corticosteroids are effective for allergic rhinitis and broadly used in daily clinical practice. Systemic oral corticosteroids are also known to be effective for treatment of allergic rhinitis. These topical and systemic corticosteroids are both effective formulations for allergic rhinitis, and both drugs have some side effects. When treatment formulations for allergic rhinitis are selected based on side effects, topical corticosteroids are more commonly selected than systemic steroids. Systemic corticosteroids, on the other hand, have traditionally been believed to have higher and more instantaneous therapeutic effects than those of topical corticosteroids. However, there have been few reports of direct comparisons between topical corticosteroid and systemic corticosteroid efficacy. The purpose of this study was to evaluate the subjective outcomes of nasal symptom management using topical intranasal corticosteroid therapy or systemic oral corticosteroid therapy in patients with seasonal allergic rhinitis. We compared the efficacy of mometasone furoate nasal spray (MFNS) to betamethasone oral tablets (BOT) for the treatment of patients with seasonal allergic rhinitis.. In an open label study, patients with seasonal allergic rhinitis who had intermediate-to-severe symptoms and who visited the hospital without prior treatment were allocated to 1 of 3 treatment groups (noncorticosteroid group, topical corticosteroid group, and oral corticosteroid group). Evaluation was conducted using allergy diaries that consisted of patient questionnaires. The Japanese Rhinoconjunctivitis Quality of Life Questionnaire (JRQLQ) was used in this study.. Compared to only loratazine nonsteroid therapy, both MFNS 200μg once daily and BOT 0.25mg twice daily significantly reduced the total and individual symptom scores for sneezing, nasal obstruction, watery nasal discharge, and nasal itching (P<0.05). Scores for itching of the eyes were reduced slightly more in the MFNS group than in the noncorticosteriod treatment group, but the difference was not significant.. MFNS and BOT have virtually equivalent effects on nasal symptoms in patients with seasonal allergies. Our study was the first direct comparison between an intranasal corticosteroid spray and a systemic oral corticosteroid for seasonal allergic rhinitis. No significant differences were found in the therapeutic effects of the topical and systemic corticosteroids tested, suggesting that topical corticosteroids are expected to sufficiently improve nasal symptoms without administration of oral corticosteroids. Treatment with intranasal corticosteroid spray is more strongly recommended than treatment with systemic corticoid steroids, due to the side effects associated with each treatment.

Topics: Administration, Intranasal; Administration, Oral; Adult; Aged; Anti-Allergic Agents; Betamethasone; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Loratadine; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Pregnadienediols; Rhinitis, Allergic, Seasonal; Young Adult

Aim of this work is to find out whether the symptoms attributable to adenoid hypertrophy in adolescents may be treated with intranasal mometasone furoate (MF) application. To learn if adenoid hypertrophy in adolescents may decrease in size with intranasal MF. A prospective, double blind, randomized, cross-over study was conducted in 28 subjects (12-18 years) with adenoidal hypertrophy. Subjects used intranasal MF or placebo for a duration of 6 weeks with a wash out period of 3 weeks. Subjective symptoms and adenoid size were evaluated. At the initiation of the study, there was no significant difference between the mean symptom scores for any of the sinonasal symptoms between the two treatment groups. There was significant improvement in total subjective symptoms (nasal blockage, rhinorrhea, cough, snoring and disruption of quality of life scores) with MF compared with placebo. Analysis of the symptoms separately showed a significant positive effect of MF on all symptoms except for rhinorrhea. Nasal endoscopic evaluation failed to demonstrate any difference in the reduction of the adenoid size between the two groups. MF has significant advantage over placebo for the symptoms attributable to adenoid hypertrophy in adolescents.

Topics: Adenoids; Adolescent; Anti-Inflammatory Agents; Child; Cough; Cross-Over Studies; Double-Blind Method; Female; Humans; Hypertrophy; Male; Mometasone Furoate; Nasal Obstruction; Nasal Sprays; Organ Size; Pregnadienediols; Prospective Studies; Snoring; Treatment Outcome

Little is known about the safety and effectiveness of early interventional treatment (EIT) with intranasal corticosteroids for seasonal allergic rhinitis. We designed a double-blinded, randomized, placebo-controlled 12-week trial of EIT with mometasone furoate nasal spray (MFNS) for Japanese cedar/cypress pollinosis (JCCP).. A total of 50 JCCP patients received MFNS (200μg once daily: n = 25) or placebo (n = 25) starting on February 1, 2010. Treatments continued until the end of April. The primary endpoint was the comparison of the total nasal symptom score (TNSS) between the MFNS and placebo groups. The secondary endpoints included comparisons of QOL, daytime sleepiness, nasal ECP levels, and safety.. Continuous dispersion of Japanese cedar pollen began on February 22. Although the placebo group showed a significant worsening of symptoms after the start of the continuous dispersion, no worsening occurred in the MFNS group. A significant difference in the TNSS between the two groups was seen starting at 4 weeks after the treatment. Similar results were seen for QOL and sleepiness. Nasal ECP levels in March were significantly lower in the MFNS group. A total of 56% of the MFNS group progressed to a persistent allergic rhinitis state in accordance with the ARIA classification, as opposed to 84% of the placebo group. MFNS was well tolerated, and the plasma cortisol concentrations were similar between the two groups.. EIT with MFNS for JCCP is both safe and effective. This treatment can potentially lessen symptoms and help pollinosis patients remain in the intermittent state.

Topics: Administration, Intranasal; Adult; Anti-Allergic Agents; Cryptomeria; Cupressus; Disease Progression; Disease-Free Survival; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Pregnadienediols; Rhinitis, Allergic, Seasonal; Treatment Outcome; Young Adult

Power-assisted turbinectomy is a safe and reliable alternative for patients with nasal blockage if nasal corticosteroid spray therapy is not suitable.. Powered-assisted partial turbinectomy was compared to the use of a corticosteroid nasal spray for relief of nasal obstruction in chronic or idiopathic rhinosinusitis.. Patients were randomized to either power-assisted partial turbinectomy or daily use of mometasone furoate nasal spray for 6 months. Evaluation by peak nasal inspiratory flow (PNIF) and grading of symptoms by use of visual analog scale was done after 3 and 6 months. Grading of symptoms was also done by use of a questionnaire approximately 30 months after the last visit.. PNIF scores improved for all patients, although significantly only for patients on mometasone spray. Patients' self-reported symptoms decreased more for operated patients. Side effects were few and mild in both groups.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Chronic Disease; Female; Humans; Inspiratory Capacity; Male; Middle Aged; Mometasone Furoate; Mouth Breathing; Multivariate Analysis; Nasal Obstruction; Nasal Sprays; Pregnadienediols; Quality of Life; Rhinitis; Severity of Illness Index; Sinusitis; Smell; Turbinates; Young Adult

Mometasone furoate nasal spray (MFNS), a potent intranasal corticosteroid with proved efficacy in relieving nasal allergic rhinitis symptoms, has demonstrated effectiveness in improving ocular symptoms associated with seasonal allergic rhinitis (SAR) in retrospective analyses.. We sought to evaluate prospectively the efficacy of MFNS in reducing total ocular symptom scores (TOSSs) and individual ocular symptoms in subjects with SAR.. Subjects 12 years or older (n = 429) with moderate-to-severe baseline symptoms were randomized to MFNS, 200 microg once daily, or placebo in this 15-day, double-blind, parallel-group study. Subjects evaluated morning instantaneous TOSSs and daily reflective TOSSs, total nasal symptom scores (TNSSs; both instantaneous TNSSs and reflective TNSSs, respectively), and individual ocular and nasal symptoms. Mean changes from baseline averaged over days 2 to 15 (instantaneous) and days 1 to 15 (reflective) were calculated. Quality of life was assessed by using the Rhinoconjunctivitis Quality of Life Questionnaire.. MFNS treatment yielded significant reductions from baseline versus placebo in instantaneous TOSSs (-0.34, P = .026, coprimary end point), instantaneous TNSSs (-0.88, P < .001, coprimary end point), reflective TOSSs (-0.44, P = .005), and reflective TNSSs (-1.06, P < .001). Significant decreases in all individual reflective ocular symptoms and instantaneous eye itching/burning and eye watering/tearing were observed for MFNS versus placebo (P < .05). Numeric improvements in instantaneous eye redness were seen but did not reach statistical significance. Improvements in Rhinoconjunctivitis Quality of Life Questionnaire total scores and individual symptom domains were achieved with MFNS treatment versus placebo (P < .001). MFNS was well tolerated.. This prospective study demonstrates that MFNS significantly reduces ocular symptoms in subjects with SAR.

Topics: Administration, Intranasal; Adult; Aerosols; Anti-Allergic Agents; Double-Blind Method; Female; Headache; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Pregnadienediols; Pruritus; Quality of Life; Retrospective Studies; Rhinitis, Allergic, Seasonal; Tears

Allergic rhinitis (AR) and related nasal congestion cause rhinitis-disturbed sleep (RDS). Intranasal corticosteroids reduce nasal congestion and improve sleep quality in AR but have not been extensively studied in RDS.. To evaluate the efficacy of mometasone furoate nasal spray (NS) on nasal symptoms, nasal patency, sleep variables, quality of life, and daytime functioning in perennial AR (PAR) and concomitant RDS.. In this double-blind 4-week study, 30 adults with PAR and moderate RDS were randomized 2:1 to receive mometasone furoate NS, 200 microg, or placebo each morning. The primary end point was the apnea-hypopnea index. Secondary outcome measures included changes in total nasal symptom score (TNSS), nighttime symptom score, daytime peak nasal inspiratory flow, nighttime flow limitation index, Rhinoconjunctivitis Quality of Life Questionnaire-Standardized (RQLQ-S) score, Epworth Sleepiness Scale score, and Work Productivity and Activities Impairment-Allergy Specific (WPAI-AS) questionnaire score. Analysis of covariance was used for all efficacy end points.. The apnea-hypopnea index at study end was not statistically significantly different between groups. However, mometasone furoate NS therapy significantly improved morning (P = .04) and evening (P = .01) TNSSs, morning (P = .049) and evening (P = .03) nasal obstruction/blockage/congestion, daily peak nasal inspiratory flow (P = .03), flow limitation index (P = .02), Epworth Sleepiness Scale score (P = .048), RQLQ-S score (P = .03), and 2 of 5 WPAI-AS domains. Among patients receiving mometasone furoate NS, TNSS improvements were significantly correlated with improved work- and non-work-related productivity.. In patients with PAR and RDS, mometasone furoate NS use improved nasal symptoms, sleepiness, and impairment in daily activities. Correlated reduced nasal symptoms and improved performance suggest that improving AR symptoms with mometasone furoate NS administration can benefit sleep and daytime functioning.

Topics: Activities of Daily Living; Administration, Intranasal; Adolescent; Adult; Anti-Allergic Agents; Female; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Pregnadienediols; Quality of Life; Rhinitis, Allergic, Perennial; Sleep Apnea Syndromes

Perennial allergic rhinitis (PAR) affects children at a young age. Current guidelines recommend intranasal corticosteroids as the first-line treatment in patients with moderate-to-severe or persistent disease or in those who have congestion. In this study, the long-term safety and efficacy of mometasone furoate nasal spray (MFNS) were assessed in children with PAR.. In this multicenter, active-controlled, evaluator-blind, 12-month study, 255 children aged 6-11 years with a >or=1-year history of PAR were randomized to receive once-daily MFNS 100 microg (n=166) or the active comparator beclomethasone dipropionate (BDP) 168 microg (n=85). Changes from baseline in overall PAR symptoms and response to treatment were rated at each visit. Cosyntropin stimulation testing, as well as tonometry and slit lamp procedures, were performed. Safety variables were assessed.. A total of 137 subjects in the MFNS group and 68 in the BDP group completed treatment. The mean reductions in physician- and subject-rated overall condition of PAR at week 52 were -42.1% and -39.7%, respectively, for MFNS, compared with -44.0% and -39.0%, respectively, for BDP. A total of 94% and 100% of MFNS and BDP subjects, respectively, reported adverse events (AEs), which were mostly mild or moderate. The most frequently reported treatment-related AEs in both groups were epistaxis, headache, and pharyngitis. Response to cosyntropin was normal and no posterior subcapsular cataracts were observed in either group. Although no significant changes in intraocular pressure were observed with MFNS, one subject receiving BDP demonstrated this effect.. Treatment with MFNS 100 microg once daily for 1 year was well tolerated in children 6-11 years old, with negligible systemic exposure and no evidence of suppression of the hypothalamic-pituitary-adrenal axis or ocular changes.

Topics: Aerosols; Anti-Allergic Agents; Anti-Inflammatory Agents; Beclomethasone; Cerebrospinal Fluid Rhinorrhea; Child; Cosyntropin; Demography; Double-Blind Method; Female; Humans; Hydrocortisone; Male; Mometasone Furoate; Nasal Obstruction; Pregnadienediols; Rhinitis, Allergic, Perennial

In subjects with mild-to-moderate nasal polyposis, treatment with mometasone furoate nasal spray (MFNS) 200 microg once daily (QD) significantly decreases nasal congestion, reduces polyp size, and improves quality of life.. To evaluate the efficacy and safety of MFNS, administered QD in the morning, in subjects with mild-to-moderate nasal polyposis.. This randomized, double-blind, double-dummy, placebo-controlled clinical trial enrolled subjects with mild-to-moderate nasal polyposis at 12 centers in Denmark, Finland, Norway, and Sweden. Inclusion criteria were: age > or = 18 years, a diagnosis of bilateral nasal polyps, and clinically significant nasal congestion. Following a 2-4-week run-in period, subjects were randomized to receive MFNS 200 microg QD or matching placebo for 16 weeks.. A total of 298 subjects were randomized to treatment. Of those subjects included in the intent-to-treat efficacy analysis (n = 291), a statistically greater proportion of the MFNS group than the placebo group had improvements in investigator-assessed nasal congestion score between baseline and end point (the primary outcome) (74.3% vs 46.8%; p < 0.001). Significant benefits of MFNS were also seen for secondary end points, including polyp size, sense of smell, peak nasal inspiratory flow, therapeutic improvement, and quality-of-life measures. MFNS was well tolerated, with no unusual or unexpected adverse events.

Topics: Administration, Intranasal; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Nasal Polyps; Pregnadienediols; Quality of Life; Treatment Outcome

A recent survey estimated that 85% of patients with allergic rhinitis experience nasal congestion. This symptom considerably impacts quality of life.. To evaluate the effectiveness of mometasone furoate nasal spray (MFNS) in subjects with seasonal allergic rhinitis (SAR) experiencing moderate-to-severe nasal congestion.. Data were obtained from 4 randomized, double-blind, placebo-controlled studies of MFNS 200 microg once daily in patients with SAR. Subject-evaluated nasal congestion score data (score range 0-3) from subjects receiving MFNS or placebo were analyzed as a pool and grouped according to baseline score (all pts. with scores >2.5, >2.75, or 3.0). The 2-week average change in score from baseline was analyzed.. Significant improvements in mean nasal congestion score were seen with MFNS (n = 490) versus placebo (n = 492; p < 0.001). Overall, there was a 27% improvement in this score in patients receiving MFNS versus 13% with placebo. MFNS produced significant reductions in the nasal congestion score compared with placebo, even in patients with the most severe baseline congestion (0.98 vs 0.52; p < 0.001). Improvements in scores from baseline of 32%, 33%, and 34% were seen with MFNS versus 22%, 21%, and 18% with placebo (for baseline scores of >2.5, >2.75, or 3.0, respectively), confirming the effectiveness of MFNS regardless of congestion severity. This represents an improvement approximating a decrease from severe to moderate congestion or from moderate-to-severe to mild-to-moderate congestion. MFNS was well tolerated.. MFNS 200 microg once daily produces statistically significant improvements in nasal congestion score compared with placebo, alleviating severe congestion in patients with moderate-to-severe SAR.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Child; Double-Blind Method; Female; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Pregnadienediols; Rhinitis, Allergic, Seasonal; Structure-Activity Relationship

Evidence in vitro suggests that benzalkonium chloride, a preservative in many intranasal preparations, interferes with ciliary function and thus could potentially interfere with mucociliary transport, the mechanism for clearing secretions from the nasal cavity.. We performed a parallel randomized study with 10 subjects in each arm comparing Rhinocort AQUA (an intranasal steroid [budesonide] spray without benzalkonium chloride) and Nasonex (an intranasal steroid [mometasone furoate] spray with benzalkonium chloride). Before and after 2 weeks of treatment, subjects completed a Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and underwent a measurement of nasal clearance of a radioactive colloidal spray into the nose.. The groups were matched at entry for nasal clearance, even though there was variability among subjects. The amount of change after 2 weeks of treatment (Delta before versus after treatment) showed a significant difference in nasal clearance favoring budesonide. After 2 weeks of treatment, both budesonide and mometasone demonstrated overall improvement in quality of life as assessed by the RQLQ. Both treatments were well tolerated.. Our study extends the observation in vitro that demonstrates the adverse effect of benzalkonium chloride on cilia to a measurement in vivo of clearance. The effects after 2 weeks might not reflect changes after longer periods of treatment.. To determine the clinical significance of the small improvement in mucociliary transport will require large clinical trials.

Topics: Administration, Intranasal; Adult; Anti-Inflammatory Agents; Budesonide; Female; Humans; Male; Mometasone Furoate; Mucociliary Clearance; Nasal Obstruction; Pregnadienediols; Quality of Life; Rhinitis, Allergic, Perennial

Cough commonly occurs as a symptom of seasonal allergic rhinitis (SAR), an inflammatory condition of the nasal mucous membranes that results in rhinorrhea, nasal stuffiness/congestion, nasal itching, and sneezing. Mometasone furoate nasal spray (MFNS, Nasonex, Schering, Kenilworth, NJ), an anti-inflammatory nasal corticosteroid, has been shown to be safe and effective in reducing the nasal inflammation of SAR.. To examine the effectiveness of MFNS in relieving SAR-associated cough, in addition to nasal symptoms.. This was a multicenter, randomized, double-blind study. Patients 12 years of age or older with > or = 1-year history of SAR symptoms, positive skin test to a prevailing seasonal allergen, moderate nasal symptoms, and moderate cough were treated for 14 days with MFNS 200 microg daily (n = 122) or placebo (n = 123).. The group treated with MFNS showed significant improvement in the daytime cough severity score at endpoint compared with placebo (P = 0.049). Improvement in the nighttime cough severity score showed a trend in favor of MFNS treatment. Treatment with MFNS significantly improved total nasal symptoms in both the daytime and nighttime compared with placebo at endpoint (P < or = 0.017). Overall daytime symptom scores (cough + total nasal) improved significantly compared with placebo at endpoint (P = 0.005). Overall nighttime symptom scores improved significantly compared with placebo at endpoint (P = 0.028). Treatments were well tolerated, with no significant differences in the incidence of adverse events.. MFNS is effective and well tolerated in the treatment of daytime cough associated with SAR.

Topics: Administration, Intranasal; Adolescent; Adult; Aerosols; Aged; Anti-Allergic Agents; Anti-Inflammatory Agents; Child; Cough; Double-Blind Method; Female; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Decongestants; Nasal Obstruction; Pregnadienediols; Pruritus; Rhinitis, Allergic, Seasonal; Safety; Sneezing; Treatment Outcome

To demonstrate the long-term efficacy of intranasal furosemide, an inhibitor of the sodium chloride cotransporter channel at the basolateral surface of the respiratory epithelial cell, vs no therapeutic intervention vs intranasal mometasone furoate, a corticosteroid, in preventing relapses of chronic hyperplastic sinusitis with nasal polyposis.. Randomized prospective controlled study. Patients were examined every 6 months during follow-up (range, 1-9 years).. One hundred seventy patients with bilateral obstructive or minimally obstructive chronic hyperplastic sinusitis with nasal polyposis.. All patients were surgically treated in the ENT Department, University of Siena Medical School. One month after surgery, group 1 patients (n = 97) started treatment with intranasal furosemide, group 2 (n = 40) received no therapeutic treatment, and group 3 (n = 33) were treated with mometasone.. Clinical and instrumental evaluation of postoperative outcomes.. Seventeen (17.5%) of 97 patients in group 1, 12 (30.0%) of 40 patients in group 2, and 8 (24.2%) of 33 patients in group 3 experienced nasal polyposis relapses. We noted a prevalence of early-stage relapse in patients treated with furosemide or mometasone, whereas patients who did not receive any treatment experienced more severe grades of chronic hyperplastic sinusitis with nasal polyposis (P<.005).. Use of intranasal furosemide represents a valid therapeutic treatment in the prevention of chronic hyperplastic sinusitis with nasal polyposis.

Topics: Administration, Intranasal; Adult; Anti-Inflammatory Agents; Chronic Disease; Diuretics; Female; Furosemide; Humans; Hyperplasia; Male; Middle Aged; Mometasone Furoate; Nasal Obstruction; Nasal Polyps; Paranasal Sinuses; Pregnadienediols; Prospective Studies; Secondary Prevention; Sinusitis; Sodium Chloride Symporters; Symporters; Treatment Outcome

Efficacy of topical nasal steroid therapy for allergic rhinitis is usually evaluated by patient and clinician assessments of subjective symptom changes in diaries and at clinical interviews.. We sought to complement the subjective measures with objective measures of nasal cytology, biochemistry, and function.. In this double-blind, randomized study patients with seasonal allergic rhinitis (SAR) 12 years of age or older received 200 microg mometasone furoate nasal spray (n = 80) or placebo spray (n = 41) once daily for 2 weeks. Subjective assessments by clinician and patient comprised symptom/sign scores and overall therapeutic response evaluations. Objective measures included nasal cytology, nasal biochemistry, nasal airway resistance (NAR), mucociliary clearance, and olfactory functions.. Mometasone furoate produced a significantly greater decrease than placebo in subjective measures of SAR for total symptom score (-46% vs -30%, p < 0.05), total nasal score (-47% vs -30%, p < 0.024), individual nasal symptom scores, and overall therapeutic response. The objective measures of eosinophil, basophil, and neutrophil counts and mucociliary clearance were significantly better in mometasone furoate- than in placebo-treated patients. Similarly, within-treatment statistically significant improvements were produced by mometasone furoate but not by placebo sprays for levels of eosinophilic cationic protein, tryptase and albumin, NAR, and odor identification. Significant positive correlations were found between NAR and nasal stuffiness and between eosinophils, basophils, and neutrophils and both eosinophilic cationic protein and albumin.. Subjective measures of SAR were significantly improved in the mometasone furoate group by comparison with placebo-treated patients. Objective assessments supported the subjective findings because within-treatment measures were frequently significantly improved after mometasone furoate treatment but not after placebo treatment.

Topics: Administration, Intranasal; Adolescent; Adult; Aged; Albumins; Anti-Allergic Agents; Anti-Inflammatory Agents; Child; Double-Blind Method; Glucocorticoids; Humans; Interviews as Topic; Middle Aged; Mometasone Furoate; Mucociliary Clearance; Nasal Mucosa; Nasal Obstruction; Outcome Assessment, Health Care; Pregnadienediols; Rhinitis, Allergic, Seasonal; Smell; Treatment Outcome

Seasonal allergic rhinitis (SAR) is a common disease of childhood and is characterized by type 2 inflammation, bothersome symptoms, and impaired quality of life (QoL). Intranasal corticosteroids are effective medications in managing SAR. In addition, mometasone furoate nasal spray (MFNS) is a well-known therapeutic option. However, the literature provided no data about the effects of MFNS in European children with SAR. Thus, this study addressed this unmet requirement.. MFNS was compared to isotonic saline. Both treatments were prescribed: one drop of spray per nostril, twice a day, for 3 weeks. Nasal cytology, total symptom score (TSS), visual analogic scale concerning the parental perception of severity of symptoms, and the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) were assessed at baseline, after 7 and 21 days, and 1 month after discontinuation.. MFNS significantly reduced eosinophil and mast cell counts, improved QoL, and relieved symptoms, as assessed by doctors and perceived by parents. These effects persisted over time, even after discontinuation. Both treatments were safe and well-tolerated.. The present study documented that a 3-week MFNS treatment was able to significantly dampen type 2 inflammation, improve QoL, and reduce severity of symptoms in Italian children with SAR, and was safe.

Topics: Child; Double-Blind Method; Humans; Inflammation; Mometasone Furoate; Nasal Obstruction; Nasal Sprays; Pregnadienediols; Quality of Life; Rhinitis, Allergic, Seasonal

Congenital midnasal stenosis (MNS) is an extremely rare disease which may be life threatening, and shows difficulty in diagnosis and management. This case series summarizes superiority of using intranasal mometasone furoate spray (IMS) and continuous positive airway pressure (CPAP) to treat nasal obstruction in neonates with MNS.. This study reviewed six consecutive cases of MNS.. Three patients were treated with IMS and CPAP. Two patients were treated with endoscopic balloon dilatation without stenting, followed by IMS and CPAP due to persisting nasal obstruction after the operation. One patient was treated with endoscopic balloon dilatation without stenting alone.. This study is the first to review the use of CPAP and IMS as an effective therapy for some patients with MNS. It suggests that conservative management with CPAP and IMS may be an alternative therapeutic option to surgery.

Topics: Administration, Intranasal; Anti-Inflammatory Agents; Conservative Treatment; Constriction, Pathologic; Continuous Positive Airway Pressure; Dilatation; Endoscopy; Female; Humans; Infant; Infant, Newborn; Male; Mometasone Furoate; Nasal Cavity; Nasal Obstruction; Nasal Sprays; Respiratory System Abnormalities

Topics: Absorbable Implants; Anti-Inflammatory Agents; Cost-Benefit Analysis; Drug-Eluting Stents; Health Care Costs; Humans; Mometasone Furoate; Nasal Obstruction; Paranasal Sinuses; Postoperative Care; Postoperative Complications; Practice Patterns, Physicians'; Procedures and Techniques Utilization; Tissue Adhesions; United States

Adenoid hypertrophy is a common cause of upper airway obstruction, and adenoidectomy is one of the most frequently performed operations in children. Topical nasal steroids can act directly on nasopharyngeal lymphoid tissue to decrease its reactive inflammatory changes and potentially reduce its size.. To study the light microscopic changes in adenoidal lymphoid tissue after one month of topical steroid use.. Twenty-six children with adenoid hypertrophy grade 3 scheduled for adenoidectomy were randomly divided into two equal groups: one group received mometasone furoate aqueous nasal spray (Nasonex) 100 mcg/day for four weeks, and a control group received nasal normal saline 0.9 per cent for four weeks. The removed adenoids were examined histopathologically.. Adenoidal tissue from the mometasone group had less reactive germinal centres and less spongiosis compared to the control group. The latter showed proliferating, reactive, variable sized and shaped lymphoid follicles, with congested blood vessels in the interfollicular areas.. The use of intranasal mometasone furoate aqueous nasal spray (Nasonex) for one month reduced adenoidal tissue reactive cellular changes and its vascularity. This is, however, a pilot study; a longer treatment period is needed to assess the effect of treatment on adenoidal size.

Topics: Adenoids; Administration, Topical; Anti-Inflammatory Agents; Child; Female; Humans; Lymphoid Tissue; Male; Microscopy; Mometasone Furoate; Nasal Obstruction; Nasal Sprays; Pilot Projects; Prospective Studies

To assess the efficacy of nasal expiratory sound analysis in determining the degree of nasal obstruction.. We have analyzed and recorded the expiratory nasal sounds in 18 healthy controls and in 30 patients with inferior turbinate hypertrophy before and after the administration of nasal corticosteroid treatment. Analysis consisted of the time-expanded waveform, spectral analysis with time-averaged fast Fourier transform and waveform analysis of nasal sound.. Before treatment, an increase in sound intensity at high frequency was observed in the sound analyses of the patients, whereas after treatment, a decrease in sound intensity at high frequency was noted in the sound analyses of the patients. The differences between the patients and the control group were statistically significant. Data obtained with the Odiosoft-Rhino method were correlated with symptom scores and endoscopic examination.. Expiratory nasal sound is a practical and objective tool, which can be reliably used not only for the assessment of the degree of nasal blockage but also for the comparison of different treatment alternatives.

Topics: Administration, Intranasal; Adult; Animals; Anti-Allergic Agents; Case-Control Studies; Female; Humans; Immunoglobulin E; Male; Mometasone Furoate; Nasal Obstruction; Pregnadienediols; Pyroglyphidae; Reproducibility of Results; Rhinitis, Allergic, Perennial; Rhinometry, Acoustic; Signal Processing, Computer-Assisted; Skin Tests

Long-term use of decongestant nasal spray (alpha adrenergic agonist) causes nasal congestion by rhinitis medicamentosa.. We clinically reviewed the cases of 33 patients of rhinitis medicamentosa (23 men, 10 women; mean age, 44.4±15.6 years) treated with nasal steroid sprays instead of decongestant nasal sprays in our clinic from October, 2011 to December, 2012.. Periods of drug use were generally long. Only 7 cases had a duration of use less than 1 year, and about half (48.5%) had a duration of use longer than 2 years. Causes of use included acute inflammation (n=6), chronic rhinosinusitis (n=2), and allergic rhinitis (n=20) and unknown cause (n=5). About two-third of the patients failed to answer questions concerning their use of decongestant nasal spray in a questionnaire prior to examination; therefore, careful observation was necessary. Among the 33 cases, 31 were followed up, all of whom showed improvement and stopped using decongestant nasal spays within 4 weeks. Periods for recovery were as follows: 3 days in 19 cases (61.3%) and 1 week in 25 cases (80.6%). Duration of drug use did not correlate with the period required for recovery; therefore, these results suggest that patients with long-term drug use are able to improve quickly.. Rhinitis medicamentosa with nasal congestion appears readily reversible with suitable treatment.

Topics: Adolescent; Adrenergic alpha-Agonists; Adult; Aged; Androstadienes; Drug Substitution; Female; Fluticasone; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Decongestants; Nasal Obstruction; Nasal Sprays; Pregnadienediols; Retrospective Studies; Rhinitis; Time Factors; Treatment Outcome; Young Adult

Chronic rhinitis and adenoid hypertrophy are the main causes of nasal obstruction in children and proper treatment of these factors seem essential for controlling nasal obstructive symptoms. This study aims to evaluate the effects of topical mometasone treatment on symptoms and size of adenoid tissue in children with complaints of nasal obstruction and to compare this approach to continuous nasal saline douching plus environmental control alone.. Fifty-one children with nasal obstructive complaints were submitted to a semi-structured clinical questionnaire on nasal symptoms, prick test and nasoendoscopy. Nasoendoscopic images were digitalized, and both adenoid and nasopharyngeal areas were measured in pixels. The relation adenoid/nasopharyngeal area was calculated. Patients were subsequently re-evaluated in two different periods: following 40 days of treatment with nasal douching and environmental prophylaxis alone; and after an subsequent 40 day-period, when topical mometasone furoate (total dose: 100μg/day) was superposed.. Nasal symptoms and snoring significantly improved after nasal douching, and an additional gain was observed when mometasone furoate was included to treatment. Saline douching did not influence the adenoid area, whereas a significant reduction on adenoid tonsil was observed after 40 days of mometasone treatment (P<0.0001).. Nasal saline douching significantly improved nasal symptoms without interfering in adenoid dimension. In contrast, mometasone furoate significantly reduced adenoid tissue, and led to a supplementary improvement of nasal symptoms.

Topics: Adenoids; Administration, Intranasal; Anti-Inflammatory Agents; Child; Child, Preschool; Chronic Disease; Cohort Studies; Environment; Female; Follow-Up Studies; Humans; Hypertrophy; Male; Mometasone Furoate; Nasal Obstruction; Observer Variation; Pregnadienediols; Rhinitis; Risk Assessment; Sodium Chloride; Statistics, Nonparametric; Therapeutic Irrigation; Treatment Outcome

To evaluate symptom scores and nasal smear cytology findings in seasonal allergic rhinitis patients, before and after treatment.. Twenty-nine consecutive adult patients with seasonal allergic rhinitis were evaluated prospectively. They received mometasone furoate nasal spray and cetirizine for 21 days. Nasal and ocular symptom scores were recorded before and after treatment. Nasal cytology was also assessed as a means of determining treatment.. The combined use of an intranasal corticosteroid and an oral antihistamine caused a significant improvement in nasal and ocular symptom scores. Cytological evaluation revealed significant reduction in nasal eosinophil, neutrophil and goblet cell counts after three weeks' treatment.. Symptom scoring systems are widely used for the evaluation of drug efficacy in allergic rhinitis treatment. When investigating the disease and evaluating treatment efficacy, objective as well as subjective methods are needed. Nasal cytological assessment is a simple, objective method which provides valuable information about the nasal mucosa.

Topics: Administration, Intranasal; Adult; Aged; Anti-Allergic Agents; Cetirizine; Drug Therapy, Combination; Female; Granulocytes; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Mucosa; Nasal Obstruction; Pregnadienediols; Prospective Studies; Rhinitis, Allergic, Seasonal; Treatment Outcome; Young Adult

The present study was performed to evaluate the effect of mometasone furoate on a nasal congestion model in Brown Norway rats.. Nasal congestion in rats sensitized with toluene-2,4-diisocyanate (TDI) was measured using whole-body plethysmography which allowed animals to move freely.. Penh (enhanced pause), an index of nasal congestion, was significantly increased after 5% TDI challenge in sensitized rats compared with that in non-sensitized rats. The peak of the increase in Penh appeared at 1 and 5 h after TDI challenge. A single topical administration of mometasone furoate (0.05%) at 1 h before TDI challenge suppressed the increase of Penh in sensitized rats. A significant effect was observed 5-6 h after nasal administration. Almost the same results were obtained with fluticasone propionate (0.05%).. Mometasone furoate may therefore be effective and have a rapid onset of action in nasal congestion when used clinically as with fluticasone propionate.

Topics: Administration, Topical; Androstadienes; Animals; Anti-Allergic Agents; Disease Models, Animal; Fluticasone; Male; Mometasone Furoate; Nasal Mucosa; Nasal Obstruction; Plethysmography, Whole Body; Pregnadienediols; Rats; Rats, Inbred BN; Respiratory Mechanics; Time Factors

Encouraging results concerning chronic obstructive nasal symptoms due to adenoid in pediatric population were reported by use of intranasal steroid for short period. Up to now, no data are available about outcomes of such therapy after long-term follow-up. We evaluated the utility of mometasone furoate aqueous nasal spray in children with adenoidal hypertrophy in long-term maintenance therapy.. All children affected by adenoidal hypertrophy and undergoing successful mometasone treatment for 4 months in a preceding trial were reassessed after a mean follow-up of 28 months. Based on the duration of maintenance therapy and eventual adenoid surgical treatment, three subgroups were identified: (1) children voluntarily suspending maintenance therapy and requiring surgery (Group A); (2) children continuing maintenance therapy but undergoing surgery (Group B); and (3) children continuing maintenance therapy but not undergoing surgery (Group C). Clinical and endoscopic evaluation in each group was compared to the assessment performed after the first 4 months of treatment.. Six patients (Group A) voluntarily suspended maintenance therapy and underwent adenoidectomy. Either the overall symptom score or choanal obstruction of this group worsened compared to the previous trial. Adenoidal surgery was performed in another three children (Group B) for ear disease. Chronic obstructive nasal symptoms and adenoid size were unchanged compared to the preceding study. Finally, 12 patients were in Group C. The overall symptom score and choanal obstruction of this group showed a further significant improvement at this stage.. This study describes the first long-term follow-up of children undergoing mometasone furoate aqueous nasal spray treatment for adenoidal hypertrophy. Voluntary suspension of maintenance therapy favors surgery of this disorder, whereas its regular administration may lead to successful results.

Topics: Adenoids; Administration, Intranasal; Administration, Topical; Anti-Inflammatory Agents; Child; Female; Follow-Up Studies; Glucocorticoids; Humans; Lymphatic Diseases; Male; Mometasone Furoate; Nasal Obstruction; Pregnadienediols