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Fluticasone Propionate Appears Effective In Treatment Of Occular Symptoms Associated With Seasonal Allergic Rhinitis

Patients who experience both nasal and ocular symptoms associated with seasonal allergic rhinitis (SAR) may benefit from intranasal fluticasone propionate (FP) monotherapy, suggests a new study.

An estimated 20-40 million people in the United States are affected by allergic rhinitis. Although symptoms primarily involve the nasal passages, ocular symptoms are also common.

Treatment of symptoms commonly consists of intranasal corticosteroids for nasal symptoms and oral antihistamines for ocular symptoms. Results of previous studies have suggested that intranasal corticosteroids may also reduce ocular symptoms.

To assess the efficacy of intranasal FP in reducing ocular symptoms of SAR, Jeffrey DeWester, MD, of DeWester, Duggan, and DeWester Family Medicine, Indianapolis, Indiana, United States, conducted a retrospective analysis of pooled efficacy data from 7 randomised, double-blind, placebo-controlled studies in which FP aqueous nasal spray, 200 µ, was given once daily for SAR nasal and ocular symptoms.

For each study, patients completed reports, rating the severity of individual nasal symptoms and overall ocular symptoms using an unmarked visual analog scale (VAS). Clinicians rated the severity of individual ocular symptoms (eye itching, tearing, redness, and puffiness) at baseline and after 7 and 14 days of treatment using the VAS, the sum of which formed the total ocular symptom score (TOSS).

The primary outcome was the mean change from baseline in TOSS. After 7 and 14 days of treatment, patients treated with FP experienced significantly greater and clinically relevant reductions in ocular symptoms compared with placebo.

Furthermore, these patients showed greater reductions in all individual symptoms assessed, with the greatest decreases observed in itching. Mean changes in patient-rated overall ocular symptoms were consistent with clinician-rated data.

The researchers note that a treatment approach with FP monotherapy may avoid increased cost, possible side effects, and decreased compliance.

The study was sponsored by GlaxoSmithKline, Inc., Research Triangle Park, North Carolina, United States.

Allergy Asthma Proc 2003 Sep-Oct;24:5:331-7. "The efficacy of intranasal fluticasone propionate in the relief of ocular symptoms associated with seasonal allergic rhinitis"

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