mometasone-furoate and Rhinitis--Allergic

Allergic rhinitis (AR) is a common disease with an important impact on the quality of life and very high management costs. In many patients, the poor control of rhinitis symptoms often requires the use of different drugs, and polytherapy tends to reduce therapeutic adherence. According to the latest version of ARIA guidelines, the currently recommended drugs for the treatment of moderate-to-severe AR are second-generation antihistamines, intranasal corticosteroids, and their combination, even in a single nasal spray device. A single medication with a rapid onset of action, acting on breakthrough symptoms too, would be advantageous, also in terms of patient compliance.. GSP301 (olopatadine 600 µg - mometasone furoate 25 µg) is a novel intranasal formulation, combining the second-generation antihistamine olopatadine hydrochloride with mometasone furoate. Here, we review the evidence for GSP301, especially concerning the efficacy and safety profile of this intranasal combination in the treatment of AR.. The evidence provided in the current review clearly supports the use of GSP301 as a novel intranasal corticosteroid/antihistamine combination with a well-documented efficacy and safety profile in terms of rapid symptom relief and good tolerability.

Topics: Administration, Intranasal; Adrenal Cortex Hormones; Anti-Allergic Agents; Drug Combinations; Histamine Antagonists; Humans; Mometasone Furoate; Olopatadine Hydrochloride; Quality of Life; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal; Treatment Outcome

Intranasal corticosteroid (INCS) has a beneficial effect on ocular symptoms in allergic rhinitis (AR). To our knowledge, the cost-effectiveness of available INCS for AR with ocular symptoms is yet to be demonstrated.. To evaluate the cost-effectiveness of INCSs including Budesonide (BANS), Mometasone furoate (MFNS), Triamcinolone (TANS), and Fluticasone furoate (FFNS) on ocular symptoms associated with AR in the Thai context.. The percentage of effectiveness in improving total ocular symptoms score (TOSS) was derived from the result of a meta-analysis that estimated the SMD of each INCS treatment compared to placebo as clinical input parameters. A cost-effectiveness analysis based on a decision-tree model to assess one-year costs and outcomes from a Thai societal perspective. The outcomes were to compare incremental cost-effectiveness ratio (ICER). Probabilistic sensitivity analyses (PSA) were also conducted to capture parameter uncertainties.. 13 eligible RCTs with a total of 3,722 patients with SAR were included in the analysis. The percentage of effectiveness of FFNS, MFNS, TANS, and BANS was 59.89%, 45.60%, 24.89%, and 16.00%, respectively. The ICER of FFNS, MFNS, and TANS is THB-6,539.92, 4,593.83, and 1,401.24 compared to BANS. CECA result showed the probability of using FFNS is considered cost-effective in 87.50% of cases from zero value followed by MFNS (0.80%), TANS (5.40%), and BANS (6.30%). With a threshold greater than THB20,000, FFNS is considered a cost-effective strategy.. FFNS is a cost-effective option compared to alternative INCSs in Thailand for treating AR with ocular symptoms.

Topics: Administration, Intranasal; Adrenal Cortex Hormones; Anti-Allergic Agents; Cost-Effectiveness Analysis; Humans; Mometasone Furoate; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal; Treatment Outcome

GSP301 is a fixed-dose combination of olopatadine hydrochloride (antihistamine) and mometasone furoate (corticosteroid). This meta-analysis aims to evaluate the efficacy and safety of GSP301 in the treatment of allergic rhinitis.. A systematic review and meta-analysis were conducted. The data were collected from PubMed, Cochrane Central Register of Controlled Trials and Embase databases till June 2021. In patients with AR, short-term (2/6 weeks) and long-term (52 weeks) effects of GSP301 were assessed. Average morning and evening 12-h reflective total nasal symptom score (rTNSS), instantaneous total nasal symptom score (iTNSS), reflective total ocular symptom score (rTOSS), instantaneous total ocular symptom score(iTOSS), Physician-assessed nasal symptom score (PNSS), rhinoconjunctivitis quality of life (RQLQ), rhinitis control assessment test (RCAT) and adverse events (AEs) were measured.. Five randomized controlled trials were included. GSP301 showed greatly improvement in rTNSS (MD = - 0.99; [95% CI - 1.19 to - 0.79]; P < 0.01; I. GSP301 is a safe and well-tolerated medication. It showed short-term benefits for seasonal and perennial AR, but may not help to improve patients' quality of life and rhinitis control in the long run.

Topics: Administration, Intranasal; Anti-Allergic Agents; Double-Blind Method; Humans; Mometasone Furoate; Nasal Sprays; Olopatadine Hydrochloride; Quality of Life; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal; Treatment Outcome

Allergic rhinitis (AR) is one the most common allergic diseases affecting from 10 to 40% of the population in different countries, including Russia. AR is a risk factor of bronchial asthma, other upper airway disease and may decrease patient quality of life, their productivity, increase probability of occupational traumatism, depression and anxiety. AR also presents a substantial economic burden. The rationale to use fixed dose combination of intranasal steroids and topical H1 antihistamines includes suboptimal control of symptoms by monotherapy, its complementary pharmacologic activity and the results of clinical trials. This review focused on fixed dose combination of intranasal mometasone furoate and olopataine. Double blind placebo-controlled and open clinical trials have confirmed that this combination decreased severity of nasal and ocular symptoms of seasonal and perennial AR, improved patient quality of life and had a good tolerability. Its efficacy was higher than those of monotherapy. Fast onset of action and sustainable effect on symptoms (during 1 yr) may improve adherence patients to the treatment and control of symptoms of AR.. Аллергический ринит (АР) является одним из наиболее распространенных заболеваний, поражающих от 10 до 40% населения в разных странах мира, в том числе и в России. Оно является значимым фактором риска развития бронхиальной астмы и болезней верхних дыхательных путей, существенно ухудшает качество жизни пациентов, оказывая отрицательное влияние на качество их сна, способность к обучению, производительность труда, может вызывать депрессию и тревогу, повышает риск производственного травматизма и из-за широкой распространенности имеет высокую стоимость лечения. Предпосылками создания для терапии АР фиксированных комбинаций, содержащих интраназальные глюкокортикостероиды и Н1-антигистаминные средства, явились потребность большинства пациентов в нескольких препаратах из-за тяжести его течения, недостаточный контроль заболевания при монотерапии, фармакологические свойства входящих в состав компонентов и результаты выполненных клинических исследований. В настоящем обзоре обсуждаются характеристики новой интраназальной комбинации, содержащей мометазона фуроат (МФ) и олопатадин (ОЛО). Результаты выполненных двойных слепых плацебо-контролируемых и открытых исследований свидетельствуют о том, что она уменьшает выраженность назальных и глазных симптомов сезонного и круглогодичного АР. Назальный спрей МФ/ОЛО улучшает качество жизни и характеризуется хорошей безопасностью. Эффективность комбинации МФ/ОЛО выше, чем у входящих в ее состав отдельных компонентов. Быстрота действия, выраженное и стойкое (в течение 12 мес) влияние на симптомы способны повысить приверженность пациентов проводимому лечению и улучшить контроль АР.

Topics: Anti-Allergic Agents; Histamine Antagonists; Humans; Mometasone Furoate; Quality of Life; Randomized Controlled Trials as Topic; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal

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

The present literature review had the objective to analyze the published data concerning the effectiveness of intranasal administration of antihistamine preparations and intranasal glucocorticoids for the treatment of allergic rhinitis. Special emphasis is placed on the clinical significance and the further prospects for the application of a fixed combination of these medications including azelastineplusmometasonefuroateas the first choice therapy of moderately severe and severe manifestations of allergic rhinitis.. Цель работы - проанализировать данные литературы, касающиеся эффективности интраназального применения антигистаминных препаратов и интраназальных гюкокортикостероидов при аллергическом рините. Подчеркнуты значение и перспективы применения фиксированной комбинации этих препаратов, в частности азеластина и мометазона фуроата, в качестве терапии первого выбора в лечении среднетяжелых и тяжелых проявлений аллергического ринита.

Topics: Administration, Intranasal; Drug Combinations; Glucocorticoids; Histamine Antagonists; Humans; Mometasone Furoate; Nasal Sprays; Phthalazines; Rhinitis, Allergic; Severity of Illness Index; Treatment Outcome

Topics: Allergens; Androstadienes; Anti-Allergic Agents; Anti-Inflammatory Agents; Bronchial Provocation Tests; Bronchodilator Agents; Environmental Exposure; Fluticasone; Humans; Mometasone Furoate; Pregnadienediols; Rhinitis, Allergic; Rhinitis, Allergic, Perennial

Nasal esketamine is indicated for the treatment of adults with treatment-resistant depression and depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior. Primary objectives of this study were to evaluate the effect of nasal decongestant pretreatment in patients with allergic rhinitis and the impact of daily nasal corticosteroid administration by healthy subjects on nasal esketamine pharmacokinetics.. Patients with allergic rhinitis self-administered 56 mg of nasal esketamine after pretreatment with nasal oxymetazoline (0.05%) at 1 h before esketamine and without oxymetazoline pretreatment. They were exposed to grass pollen in an allergen challenge chamber to induce allergic rhinitis symptoms at approximately 2 h before each esketamine administration until 1 h after. Healthy subjects self-administered esketamine (56 mg) before and after administration for 16 consecutive days of mometasone (200 µg), with the second esketamine dose administered 1 h after the last mometasone dose. The plasma pharmacokinetics of esketamine and noresketamine were assessed after each esketamine administration. The tolerability of esketamine, including effects on dissociative and potential psychotomimetic symptoms and level of sedation and suicidal ideation and behavior, was evaluated.. The rate of esketamine absorption was slightly greater in patients exhibiting symptoms of allergic rhinitis (decrease in median t. Patients exhibiting symptoms of rhinitis may receive nasal esketamine spray without dose adjustment. In addition, esketamine may be administered 1 h after using a nasal decongestant or corticosteroid.. The study was registered in the Clinical Trials (NCT02154334) and EudraCT (2014-000534-38) registries.

Topics: Administration, Intranasal; Adrenal Cortex Hormones; Adult; Depressive Disorder, Major; Double-Blind Method; Healthy Volunteers; Humans; Mometasone Furoate; Nasal Decongestants; Nasal Sprays; Oxymetazoline; Rhinitis, Allergic

This study aimed to investigate the efficacy and safety of vitamin D supplementation in the treatment of allergic rhinitis (AR) using mometasone. A total of 140 patients with moderate and severe AR treated at our hospital between January 2017 and August 2020 were recruited as subjects for this study. The patients were randomly divided into control and experimental groups, with 70 patients in each group. Mometasone nasal spray was used in both groups, and vitamin D was administered to the experimental group for four weeks. The total nasal symptom scores (TNSS) and rhinoconjunctivitis quality of life questionnaire (RQLQ) were used to assess the efficacy of treatment. T lymphocyte subsets (CD3+, CD4+ and CD8+) and serum anti-inflammatory and proinflammatory cytokines such as interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) were analyzed. The incidence of adverse reactions was recorded. Serum vitamin D levels were lower in patients with AR. After 4 weeks of treatment, total TNSS scores, T lymphocyte subsets (CD3+, CD4+), CD4+/CD8+ ratio, TNF-α, and total RQLQ scores were significantly reduced compared to the initial testing (P<0.05) in the two groups; CD8+, IFN-γ, and IL-10 levels as well as serum vitamin D were significantly increased compared to the initial test (P<0.05). The improvement in these parameters in the experimental group was significantly greater than that in the control group (P<0.05), except for sneezing and eye symptoms in the TNSS and RQLQ scores. It was concluded that vitamin D supplementation improves the therapeutic effect of mometasone nasal spray on AR and is thus recommended as an adjuvant therapy for moderate and severe AR.

Topics: Dietary Supplements; Humans; Interferon-gamma; Interleukin-10; Mometasone Furoate; Nasal Sprays; Quality of Life; Rhinitis, Allergic; Tumor Necrosis Factor-alpha; Vitamin D; Vitamins

We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions.. The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test.. The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant (. Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.

Topics: Administration, Intranasal; Adult; Anti-Allergic Agents; Chamomile; Female; Humans; Isotonic Solutions; Male; Middle Aged; Mometasone Furoate; Mucociliary Clearance; Nasal Sprays; Phytotherapy; Plant Extracts; Rhinitis, Allergic; Seawater; Therapeutic Irrigation; Young Adult

To investigate the effect of drug treatment combined with psychological intervention on mental disorders in patients with persistent moderate-severe allergic rhinitis.. Sixty patients with persistent moderate-severe allergic rhinitis who met the criteria were randomly divided into 2 groups: control group and experimental group. The control group was only given medication, whereas the experimental group was given psychological intervention on the basis of the same medication. Cognitive behavioral therapy was used for psychological intervention. After 12 weeks of treatment, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) were used to evaluate the changes in anxiety, depression, and quality of life before and after treatment.. The SAS and SDS scores of the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similarly, the SAS and SDS scores of the experimental group after treatment were lower than those before treatment with statistically significant difference. In addition, after treatment, the SAS and SDS scores of the experimental group were statistically lower than those of the control group. The results of RQLQ showed that the scores of each dimension in the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similar results were found in the experimental group. After treatment with these 2 different schemes, the RQLQ scores of sleep, nonnasal/eye symptoms, and emotion in the experimental group were statistically lower than those in the control group.. Drug therapy or drug therapy combined with psychological intervention can alleviate anxiety and depression of patients with persistent moderate-severe allergic rhinitis and improve their quality of life. Moreover, based on the effect of improving mental disorder and quality of life of patients, drug therapy combined with psychological intervention is better than drug treatment alone.

Topics: Adolescent; Adult; Anti-Allergic Agents; Anxiety; Cognitive Behavioral Therapy; Combined Modality Therapy; Depression; Drug Therapy, Combination; Female; Humans; Loratadine; Male; Middle Aged; Mometasone Furoate; Psychosocial Intervention; Quality of Life; Rhinitis, Allergic; Self Report

Allergic fungal rhinosinusitis (AFRS) is a common disorder with a high prevalence and a very high incidence of recurrence. Management includes surgery and medical treatment in the form of local and/or systemic steroids. However, some cases are resistant to the action of steroids and further treatment is warranted. Being an immune-mediated disorder, targeting IgE seems a logical step. Immunotherapy drugs acting on the IgE (e.g. omalizumab) can modify the clinical course of the disease. This study aimed at evaluating the effect of omalizumab on the clinical course of patients undergoing surgery for AFRS.. This is a two-arm prospective, randomized, single blind clinical trial among patients with AFRS. Twenty patients were included and randomly divided into two groups: Group A; 10 patients received a single subcutaneous injection of omalizumab (Xolair ' Novartis) (150 mg) 2 weeks postoperatively. Group B: 10 patients received local steroids nasal sprays (budesonide or mometasone furoate, 100 μg twice daily for 6 months, starting 2 weeks postoperatively. All patients underwent history, examination, CT scan and IgE level estimation and were submitted to endoscopic sinus surgery. They were evaluated at 4 weeks interval for 6 months.. In both groups there were highly significant differences between pre/post-operative SNOT-20 scores, TNSS scores, total IgE level and Philpott-Javer staging scores. Comparison between the two study groups at 24 weeks showed a highly significant difference (p = 0.001) between post-operative SNOT 20 and TNSS scores in favour of group A. There was no statistically significant difference between the two study groups as regarding postoperative total IgE or Philpott-Javer scores. There were two recurrences in both arms, but no significant side effects.. We compared a single post operative injection of omalizumab with twice daily intranasal steroid spray for 6 months. Both treatments were effective, but the omalizumab group showed a more significant clinical and endoscopic response. There were no significant side effects in both arms. This novel approach used a single low dose injection of omalizumab increased the compliance of the patients with minimal complications. Longer follow-up of the patients is ongoing to determine the optimal time for re-injection. The only downside was the higher cost of omalizumab compared to that of local steroids.

Topics: Administration, Intranasal; Adolescent; Adult; Anti-Allergic Agents; Budesonide; Chronic Disease; Endoscopy; Female; Glucocorticoids; Health Status Indicators; Humans; Immunoglobulin E; Injections, Subcutaneous; Male; Mometasone Furoate; Mycoses; Nasal Polyps; Nasal Sprays; Omalizumab; Prospective Studies; Rhinitis, Allergic; Single-Blind Method; Sinusitis; Tomography, X-Ray Computed; Young Adult

Allergic rhinitis (AR) is caused by an IgE-mediated inflammatory reaction consequent to the exposure to the causal allergen. Glycyrrhetic acid (GlyAc) is a natural compound extracted from the liquorice that exerts anti-inflammatory activity. This real-life study compared intranasal GlyAc, present in a medical device containing also glycerol and mannitol, with mometasone furoate nasal spray (MFNS) in 50 adult outpatients with AR. Both treatments lasted 2 months. Endoscopic signs, perception of symptom severity, assessed by VAS, and nasal function measured by rhinomanometry were evaluated at baseline (T0), after one (T1) and two (T2) months. The intergroup analysis showed that at T1 there was no significant difference between groups about the use of decongestants and antihistamines, turbinate hypertrophy and pale mucosa, perception of olfaction and snoring. At T2 there was no significant difference between groups about use of relievers, all endoscopic signs, and perception of nasal discomfort, nasal obstruction, olfaction, and snoring. The intragroup analysis showed that in MFNS group there was a significant change during the entire period of treatment for all parameters except watery rhinorrhea (sign) and ocular discomfort; in GlyAc group there was a significant change during the entire period of treatment for all parameters. In conclusion, this preliminary study, conducted in clinical practice, evidenced that intranasal CysAC plus mannitol was able to significantly improve nasal endoscopic signs, perception of symptoms, and nasal function in patients with AR. Therefore, GlyAc could be a reasonable therapeutic option to control allergic inflammation.

Topics: Administration, Intranasal; Adult; Anti-Allergic Agents; Anti-Inflammatory Agents; Female; Glycyrrhetinic Acid; Humans; Male; Middle Aged; Mometasone Furoate; Nasal Sprays; Prospective Studies; Rhinitis, Allergic

Allergic rhinitis is a common ailment with rising trend and worldwide prevalence of some 400 million.. This prospective randomized crosssectional study was done at the Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University, Teaching Hospital, Kathmandu, Nepal from June 2016 to August 2017. They were randomly assigned to two groups by lottery method. Group A received mometasone furoate intranasal spray and Group B received oral montelukast for a total duration of one month. Prior to starting medication and one month after medications, total nasal symptom score was documented. Statistical analysis was done using SPSS version 18.. Total of 126 patients between 16 to 52 years were enrolled in the study. The mean duration of symptoms was 3.93 years. The mean value of serum total IgE was 833.49 IU/ml. The mean pre and post medication score for mometasone furoate intranasal spray group was 16.32 and 5.44 respectively, which was significant. Similarly, the mean pre and post medication score for oral montelukast group was 15.24 and 7.87 respectively which was also found to be significant. Comparing the means of scores for both the groups, mometasone furoate was found to be more effective than oral montelukast.. Both mometasone furoate intranasal spray and oral montelukast were effective in the treatment of patient with allergic rhinitis. Oral montelukast can therefore be used as a first line treatment for patients with allergic rhinitis.

Topics: Acetates; Anti-Allergic Agents; Cyclopropanes; Humans; Mometasone Furoate; Nepal; Pregnadienediols; Prospective Studies; Quinolines; Rhinitis, Allergic; Sulfides; Treatment Outcome

Topics: Administration, Intranasal; Anti-Allergic Agents; Butyrophenones; Double-Blind Method; Drug Therapy, Combination; Histamine H1 Antagonists; Humans; Mometasone Furoate; Piperidines; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal

Topics: Acetates; Administration, Intranasal; Anti-Allergic Agents; Cyclopropanes; Double-Blind Method; Drug Therapy, Combination; Glucocorticoids; Histamine Antagonists; Humans; Leukotriene Antagonists; Loratadine; Mometasone Furoate; Quinolines; Rhinitis, Allergic; Sulfides; Treatment Outcome

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

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

Topics: Administration, Intranasal; Androstadienes; Anti-Allergic Agents; Double-Blind Method; Fluticasone; Humans; Mometasone Furoate; Olopatadine Hydrochloride; Phthalazines; Rhinitis, Allergic

To summarize effective intranasal glucocorticosteroids (GCS) application strategies in treatment of patients, suffering from allergic rhinitis (depending on disease type), based on actual research results. Current study determines the place of fixed intranasal GCS and topic antihistamine medication combination, specifically azelastine and mometasone furoate, as a first line of choice therapy in treatment of patients, suffering from allergic rhinitis. Effective application of stage therapy allows us establish control over allergic inflammation and significantly decrease pharmaceutical load in cases of patients, suffering from allergic rhinitis.. На основании результатов современных исследований обобщить эффективные стратегии использования интраназальных глюкокортикостероидов в лечении пациентов с аллергическим ринитом в зависимости от фенотипа заболевания. Обсуждается место фиксированной комбинации интраназальных глюкокортикостероидов и топических антигистаминных препаратов, в частности азеластина гидрохлорида и мометазона фуроата, в качестве терапии первого выбора в курсовом лечении пациентов с аллергическим ринитом. Эффективное использование алгоритма ступенчатой терапии позволит достичь контроля аллергического воспаления и существенно уменьшить фармаконагрузку на пациента с аллергическим ринитом.

Topics: Administration, Intranasal; Evidence-Based Medicine; Humans; Mometasone Furoate; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal

Topics: Administration, Intranasal; Anti-Allergic Agents; Humans; Mometasone Furoate; Rhinitis, Allergic

The purpose of this study is to determine the post-treatment levels of total oxidant status (TOS) and total antioxidant status (TAS), that are increased due to pathophysiology, and to compare those with pre-treatment levels in allergic rhinitis patients.. While no significant change was determined in mean TAS levels with treatment, a statistically significant decrease was determined in TOS values in post-treatment period (P < .01). There was no significant change in TAS and TOS values of patients only using nasal steroids, while a significant decrease was determined in post-treatment TOS values of patients using both nasal steroids and oral antihistamines (P < .001). It was determined that TOS values of women were significantly lower compared to men, and it was also reduced in seasonal allergic rhinitis compared to perennial allergic rhinitis (P < .05 for both).. In allergic rhinitis patients, concomitant use of nasal steroids and antihistamines significantly decreases total oxidative stress. It may be stated that the addition of antihistamines to allergic rhinitis treatment positively affects treatment.

Topics: Administration, Intranasal; Anti-Allergic Agents; Antioxidants; Female; Histamine H1 Antagonists; Humans; Male; Mometasone Furoate; Oxidative Stress; Pregnadienediols; Rhinitis, Allergic; Steroids

Pharmacotherapy for allergic rhinitis is based on different categories of drugs used either in monotherapy or in combination regimens. The current clinical guidelines suggest a stepwise approach to pharmacotherapy for allergic rhinitis. The use of intranasal corticosteroids is considered as the preferred second-stage pharmacotherapy. Inadequate control of AR symptoms in first-line therapy is a common problem. Integrated care pathways (ICP), developed taking into account the data obtained about patients using a mobile application, suggest the use of intranasal corticosteroids as the first line of therapy, including in patients with intermittent rhinitis who have not previously received treatment when assessing the condition according to the VAS for more than 5 points, in patients who received earlier treatment when assessing the condition according to the VAS less than 5 points. According to the data in the medical decision support system and continuing medical education UpToDate, inhaled corticosteroids are considered as the first-line drugs for the pharmacotherapy of allergic rhinitis. In terms of pharmacodynamic efficacy, intranasal corticosteroids are comparable to each other. The selection criteria can be considered: the value of systemic absorption; lipophilicity; the start time of the action; frequency of introduction, organoleptic properties; the possibility of influencing non-nasal symptoms. The use of sprays containing both a glucocorticoid and an antihistamine (mometasone furoate/azelastine hydrochloride) opens up additional pharmacotherapeutic possibilities in the treatment of allergic rhinitis.. Фармакотерапия аллергического ринита основана на различных категориях препаратов, используемых либо в монотерапии, либо в комбинированных схемах. Действующие клинические рекомендации предполагают ступенчатый подход к проведению фармакотерапии при аллергическом рините. Применение интраназальных глюкокортикостероидов (ГКС) рассматривается в качестве предпочтительной фармакотерапии на второй ступени. Недостаточный контроль симптомов аллергического ринита при назначении терапии первой линии является частой проблемой. Интегрированные схемы лечения (ICP), разработанные с учетом данных, полученных от пациентов с использованием мобильного приложения, предполагают в качестве первой линии терапии применение интраназальных ГКС, в том числе у пациентов с интермиттирующим ринитом, не получавших ранее лечения, при оценке состояния по визуально-аналоговой шкале (ВАШ) более 5 баллов, а также у пациентов, получавших ранее лечение, при оценке состояния по ВАШ менее 5 баллов. Согласно данным системы поддержки принятия медицинских решений и непрерывного медицинского образования UpToDate, ингаляционные ГКС рассматриваются в качестве препаратов первой линии фармакотерапии аллергического ринита. По фармакодинамической эффективности интраназальные ГКС сопоставимы между собой. В качестве критериев выбора можно рассматривать: величину системной абсорбции; липофильность; время начала действия; кратность введения; органолептические свойства; возможность влияния на неназальные симптомы. Применение спреев, содержащих как ГКС, так и антигистаминный препарат (мометазона фуроат / азеластина гидрохлорид), открывает дополнительные фармакотерапевтические возможности в лечении аллергического ринита.

Topics: Administration, Intranasal; Anti-Allergic Agents; Humans; Mometasone Furoate; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal; Treatment Outcome

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

Background Mometasone furoate, one of the second generation intranasal corticosteroids, is currently used in suspension form due to its poor solubility. However, this is not favorable for nasal application because of the rapid elimination of the instilled drug from the nasal cavity by mucociliary clearance and delayed onset of action due to the slow dissolution of drug in suspension. Objective The aim of this study was to determine the antiallergic effects of mucoadhesive thermosensitive in situ gel containing mometasone furoate that we developed previously to prolong the contact between the drug and nasal mucosa and to prevent drainage of the formulation in an ovalbumin-induced rat model of allergic rhinitis. Methods An experimental allergic rhinitis model was developed in female Wistar albino rats by intraperitoneal injection of ovalbumin every 2 days for 14 days followed by its repeated intranasal instillation for 7 consecutive days. Intranasal instillation of ovalbumin was continued every other day for 14 days. Mometasone furoate in situ gel (5 μg/10 µl), mometasone furoate suspension (5 μg/10 µl), and physiological saline (10 µl) were administered into the bilateral nasal cavities from day 22 to day 35. Antiallergic effects were evaluated through histopathological evaluation, analysis of ovalbumin-specific serum immunoglobulin E, and a symptom score. Results Mometasone furoate in situ gel significantly decreased the nasal symptoms and ovalbumin-specific serum immunoglobulin E level as compared with mometasone furoate suspension and physiological saline. Additionally, inflammatory histological symptoms such as mucosal edema, vascular dilatation, eosinophil infiltration, and loss of cilia within the nasal mucosa of allergic rhinitis model rats were remarkably improved with the treatment of mometasone furoate in situ gel. Conclusion These results suggest that mometasone furoate in situ gel has a better therapeutic potential for the treatment of allergic rhinitis compared to mometasone furoate suspension.

Topics: Administration, Intranasal; Animals; Anti-Allergic Agents; Disease Models, Animal; Female; Gels; Immunoglobulin E; Mometasone Furoate; Nasal Cavity; Ovalbumin; Rats; Rats, Wistar; Rhinitis, Allergic; Temperature; Treatment Outcome

We aimed to investigate whether quercetin had a therapeutic effect in an experimental rat model of allergic rhinitis. The study was conducted with 35 rats, which were randomly assigned into 4 groups: group 1 (n = 5), sham group; group 2 (quercetin group, n = 10) received 80 mg/kg day quercetin; group 3 (steroid group, n = 10) received steroid (mometasone furoate); and group 4 (control group, n = 10), received ovalbumin alone. Rats were sensitized by administration of ovalbumin on alternate days over 14 days via an intraperitoneal route. On day 15, in addition to ovalbumin via an intranasal route, quercetin and steroid were given over 7 days to the corresponding groups. All rats were then sacrificed and nasal turbinates were evaluated histopathologically, and serum total IgE and ovalbumin (OVA)-specific IgE values were measured before and after treatment. A significant increase in OVA-specific IgE values was detected in all groups except sham group. A significant increase was detected in post-treatment total IgE levels in the control group, while no significant change was detected in the sham, quercetin, and intranasal steroid groups. On histopathological evaluation, it was observed that findings of allergic rhinitis were suppressed in the quercetin group when compared to the control group. In immunohistochemical evaluation, it was detected that COX-2 and VIP expressions were weaker in the quercetin group compared to the control group. Based on these findings, we conclude that quercetin was effective in allergic rhinitis induced by ovalbumin in rats both histopathologically and serologically.

Topics: Administration, Intranasal; Animals; Anti-Allergic Agents; Antioxidants; Cyclooxygenase 2; Disease Models, Animal; Immunoglobulin E; Mometasone Furoate; Ovalbumin; Quercetin; Random Allocation; Rats; Rhinitis, Allergic; Turbinates

To evaluate the factors which may be related to nonadherence to intranasal corticosteroids (ICS) in the treatment of allergic rhinitis (AR) in children.. A prospective study was conducted on children with AR diagnosis in a tertiary referral hospital. All participants were provided with mometasone furoate nasal sprays for 30 days after the diagnosis. Caregivers were called back when the therapy was over and completed a questionnaire about the factors that may influence the adherence to the treatment. Afterwards each caregiver completed the Turkish language validated Morisky Medical Adherence Scale (MMAS-8) form. Each factor was evaluated according to MMAS-8 score and all variables were analyzed statistically.. A total number of 76 children with a mean age of 7.82 years were included in the study. The mean overall MMAS-8 score was 2.80. There was only one factor significantly related to low adherence; the number of dependent children to the caregiver (p = 0.011). Besides this 71.51% of the answers to MMAS-8 scale were compatible with good adherence.. The clinician must consider the factors which may lead to non-adherence while setting up a treatment plan. The demographic and sociocultural factors must be taken into consideration and treatment schedule should be made in respect of daily activities of the children. Moreover the father can be involved in the therapy plan and back up the mother as they are usually the responsible parent for children's medical therapy.

Topics: Administration, Intranasal; Anti-Allergic Agents; Child; Female; Glucocorticoids; Humans; Male; Medication Adherence; Mometasone Furoate; Nasal Sprays; Prospective Studies; Rhinitis, Allergic; Surveys and Questionnaires

Topics: Administration, Intranasal; Administration, Oral; Anti-Allergic Agents; Bifidobacterium; Clostridium; Histamine H1 Antagonists, Non-Sedating; Humans; Interleukin-10; Loratadine; Mometasone Furoate; Nasal Mucosa; Quality of Life; Rhinitis, Allergic; Tablets; Transforming Growth Factor beta1; Treatment Outcome

The purpose of the present work was to develop a mucoadhesive thermoreversible nasal gel with a tailored gelling temperature to provide the prolonged contact between mometasone furoate and the nasal mucosa and in order to prevent drainage of the formulation. For this purpose, in situ gel containing a thermogelling polymer poloxamer 407 (Pluronic® F-127) and a mucoadhesive polymer Carbopol® 974P NF was prepared. In this content, formulations were designed to have gelation temperature below 34°C to obtain gelation at intranasal cavity. Evaluation of the prepared in situ gels was carried out by the determination of sol-gel transition temperature, rheological and mechanical characteristics, mucoadhesion strength, drug content, physicochemical stability, in vitro release profiles, and ex vivo permeation across sheep nasal mucosa of formulations. Consequently, the in situ gel (CP5) which had favorable gelation temperature (30.1 ± 0.24°C), rheological and mechanical characteristics, in vitro release profile (T%100 180 min), and mucoadhesion strength (0.289 ± 0.0069 mJ) was developed. Consequently, the in situ gel system has been concluded as a promising approach in order to improve the therapeutic effects of intranasal mometasone furoate administration.

Topics: Administration, Intranasal; Animals; Drug Compounding; Drug Liberation; Gels; Mometasone Furoate; Nasal Mucosa; Poloxamer; Rhinitis, Allergic; Sheep; Temperature

In this study, we aimed to evaluate the histopathological effects of thymoquinone treatment of the nasal mucosa in a rabbit model of allergic rhinitis, and we compared its effects with those of nasal mometasone furoate.. A total of 24 male New Zealand rabbits were used. The animals were randomly assigned to one of four groups. Group 1 received no treatment, while group 2 underwent ovalbumin (OVA) sensitization only. Group 3 was the study group; after OVA sensitization, the rabbits were treated with intranasal thymoquinone. The group 4 rabbits received mometasone furoate for 7 days after OVA sensitization. Mucosal structures were stained with hematoxylin and eosin, while toluidine blue was used to stain mast cells. Apoptosis was evaluated using a TUNEL assay.. In the positive control groups, including the thymoquinone and intranasal mometasone furoate groups, intraepithelial and submucosal inflammation and goblet cell hypertrophy were significantly decreased compared to group 2 (p < 0.001). The cilial structure was normal, as was the chondrocyte structure in both treatment groups.. This is the first study to evaluate the histopathological effects of thymoquinone in an allergic rhinitis model. Thymoquinone reduced allergic inflammation and may be valuable for treating allergic rhinitis. However, additional studies are needed.

Topics: Administration, Intranasal; Adrenal Cortex Hormones; Animals; Apoptosis; Benzoquinones; In Situ Nick-End Labeling; Male; Mometasone Furoate; Rabbits; Random Allocation; Rhinitis, Allergic

There is growing knowledge about the immunoregulatory and possibly preventative roles of immunoglobulin A (IgA) in allergic diseases. This study aimed to investigate secretory immunoglobulin A (SIgA) levels in the nasal fluid of children who were either being treated for their allergic rhinitis (AR) with intranasal mometasone furoate or were not receiving treatment.. The study population contained 55 children with persistent AR. Group I included 27 newly diagnosed AR patients not taking any medication and group II included 28 patients treated with intranasal steroids for at least 6 months. 27 healthy control subjects were also enrolled in the study. Total symptom scores (TSS) were calculated for each patient. Nasal secretions were obtained using a new modified polyurethane sponge absorption method, and samples were analysed by ELISA.. The median value for nasal fluid SIgA level in each group was 127.2μg/ml (interquartile range; 67.3-149.6) in group I, 133.9μg/ml (102.1-177.8) in group II and 299.8μg/ml (144.5-414.0) in the control group. Groups I and II both had statistically significant reductions in nasal fluid SIgA levels compared to the control group (p<0.001). However, there was no statistically significant difference between groups I and II (p=0.35). A statistically significant and negative correlation also existed between TSS and nasal fluid SIgA levels in both groups I and II (p=0.006, rho=-0.512 and p=0.01, rho=-0.481, respectively).. SIgA levels in the nasal fluid are significantly reduced in children with AR independent of treatment and are negatively correlated with the TSS.

Topics: Administration, Intranasal; Adolescent; Anti-Allergic Agents; Case-Control Studies; Child; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin A, Secretory; Male; Mometasone Furoate; Nasal Lavage Fluid; Rhinitis, Allergic; Skin Tests; Spirometry

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

Glucocorticoids (GCs) are well known for their anti-inflammatory effects, which are elicited through a transcriptional mechanism via a cytosolic glucocorticoid receptor (cGR)-mediated genomic effect. However, recent in vitro studies report that GCs can act as a membrane glucocorticoid receptor (mGR). This study aimed to examine whether mometasone furoate (MF) influences the nasal symptoms induced by histamine, substance P, ATP. Furthermore, the influences of various compounds on MF action were studied in vivo. The mice were intranasally administered with nasal symptom-inciting agents, and the occurrences of sneezing and nasal rubbing were counted. MF repressed the nasal symptoms caused when it was administered 10, 30 and 60min before the induction of nasal symptoms. The repressive effect observed 10min after the administration of MF was inhibited by RU486, a GR antagonist, but not by actinomycin D, a transcriptional inhibitor. In contrast, the repressive effect observed 60min after the administration of MF was inhibited by RU486 and actinomycin D. Therefore, the effects observed 10 and 60min after the MF administration were classified as non-genomic and genomic effects, respectively. The non-genomic effect suppressed the nasal symptoms induced by m-3M3FBS, a phospholipase C (PLC) activator, and was inhibited by U-73122, a PLC inhibitor. The genomic effect was inhibited by N-(p-amylcinnamoyl) anthranilic acid, a phospholipase A2 (PLA2) inhibitor. These results indicate that MF has a non-genomic effect through repression of the activation of PLC via the mGR, and MF has also a genomic effect that was influenced by the inhibition of PLA2 through transcriptional regulation via cGR.

Topics: Adenosine Triphosphate; Animals; Behavior, Animal; Cinnamates; Disease Models, Animal; Estrenes; Female; Genomics; Glucocorticoids; Histamine; Hormone Antagonists; Mice; Mice, Inbred ICR; Mifepristone; Mometasone Furoate; ortho-Aminobenzoates; Phospholipase A2 Inhibitors; Pregnadienediols; Pyrrolidinones; Receptors, Glucocorticoid; Rhinitis, Allergic; Rhinitis, Allergic, Perennial; Sneezing; Substance P; Type C Phospholipases