Treatment of seasonal allergic rhinitis with fluticasone propionate aqueous nasal spray: review of comparator studies

Studies have been conducted in the USA comparing fluticasone propionate aqueous nasal spray 200 μg once daily with beclomethasone dipropionate aqueous nasal spray 168 μg twice daily, oral terfenadine 60 mg twice daily, or oral astemizole 10 mg once daily given for 2 or 4 weeks during tree, grass or ragweed pollen seasons. All six were multicentre, randomised, placebo-controlled, double-blind, parallel-group studies. Eflicacy was evaluated by patient and clinician assessments of individual nasal symptoms and overall response to therapy. Fluticasone propionate was superior to beclomethasone dipropionate in one trial according to patient evaluations of symptoms, but response to fluticasone propionate and beclomethasone dipropionate was similar in the second study. Comparisons with antihistamines showed fluticasone propionate to have greater eflicacy. It was more eflective than terfenadine in both trials according to evaluations by clinicians and patients. Similar findings were observed in the first astemizole trial. The second astemizole study showed superiority of fluticasone propionate over astemizole in terms of patient and clinician evaluations of overall response to therapy and occasionally in terms of symptom evaluations. There were no significant adverse eflects, including eflects on plasma cortisol concentrations, noted in any of these comparator studies.