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Efficacy of fluticasone exhalation delivery system in the management of chronic rhinosinusitis: what is the evidence?
Author(s) -
Kuan Edward C.,
Kovacs Alexander J.,
Workman Alan D.,
Bosso John V.,
Adappa Nithin D.
Publication year - 2019
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22340
Subject(s) - medicine , fluticasone , chronic rhinosinusitis , nasal polyps , exhalation , nasal administration , nasal cavity , sinusitis , nose , chronic sinusitis , fluticasone propionate , surgery , anesthesia , dermatology , corticosteroid , pharmacology
Background Intranasal steroids have become part of the mainstay in the long‐term management of chronic rhinosinusitis. A long‐standing problem remains in efficient and easy‐to‐use delivery of topical corticosteroids to the nasal mucosa. Currently available means of intranasal steroid delivery include sprays, which are generally limited to treating the anterior nasal cavity, and rinses, which are not FDA‐approved for this indication. The exhalation delivery system is a novel method of delivering fluticasone to the deeper areas within the nasal cavities, including the posterior nasal cavity and middle and superior meatuses. Methods Comprehensive literature review. Results Recent large scale studies have suggested its efficacy and safety in the use of patients with both chronic sinusitis with polyposis and without polyps. Specifically, studies have demonstrated decreased Sinonasal Outcome Test scores of 20 points following treatment, as well as improvement of polyp grade by 1 or more point in more than 60% of patients. Furthermore, among patients with nasal polyps, there was approximately 60‐70% decreased indication for surgery following EDS‐FLU use. Conclusion EDS‐FLU is an important adjunct therapy for sinonasal inflammatory disease.