Nasal Sprays for Allergic Rhinitis

Nasal steroids are a mainstay of treatment for allergic rhinitis. Mechanisms of symptom relief include vasoconstriction, decreased membrane permeability, and blunted immune responses. Of the available steroids, no clear guidance exists to provide rationale for use of one agent over another, save the standard issues of cost, dose frequency, and cosmetic issues like fragrance or after-taste. This study compared two popular once-daily nasal steroids, triamcinolone acetonide vs. fluticasone propionate, in 233 Spring allergic rhinitis patients. Outcome measurements included rhinorrhea, nasal congestion, sneezing, and itching and a composite of all four symptoms at baseline and three weeks later.

Both products were equally efficacious in individual symptom reduction as well as composite scores. Modest, statistically significant side effect profile differences were detected between the products. Triamcinolone was significantly less likely to be reported as running down the throat or out of the nose. On the other hand, fluticasone was less likely to cause dry nostril sensation or a sensation of a stuffed-up nose.

Triamcinolone and fluticasone are equally efficacious in symptom control of allergic rhinitis.

Small P, et al. J Allergy Clin Immunol 1997;100:592-595.