For patients with chronic rhinosinusitis (CRS), an exhalation delivery system that delivers fluticasone (EDS-FLU) to sinonasal areas above the inferior turbinate is efficacious, irrespective of nasal polyps, according to a study published in the Journal of Allergy and Clinical Immunology: In Practice. James Palmer, MD, and colleagues examined EDS-FLU efficacy for CRS in two randomized, EDS-placebo-controlled trials in adults with CRS irrespective of polyps (ReOpen1; 332 patients) or exclusively without polyps (ReOpen2; 223 patients). For 24 weeks, patients received EDS-FLU one or two sprays per nostril or EDS-placebo twice daily. The composite symptom score least-squares mean change for EDS-FLU one or two sprays per nostril versus EDS-placebo were −1.58 and −1.60 versus −0.62 in ReOpen1, and −1.54 and −1.74 versus −0.81 in ReOpen2. Sinus opacification least-squares mean changes for one or two sprays per nostril of EDS-FLU versus EDS-placebo were −5.58 and −6.20 versus −1.60 in ReOpen1 and −7.00 and −5.14 versus +1.19 in ReOpen2. Compared with EDS-placebo, acute disease exacerbations were reduced by 56% to 66% with EDS-FLU. For patients using standard-delivery nasal steroid products just before entering the study, there were significant symptom reductions of a similar magnitude observed. Similar adverse events were seen to those with standard-delivery intranasal steroids.
