Onset of symptomatic effect of mometasone furoate nasal spray in the treatment of nasal polyposis

J Allergy Clin Immunol. 2008 Apr;121(4):928-32. doi: 10.1016/j.jaci.2007.11.018. Epub 2008 Jan 30.

Abstract

Background: The efficacy of the intranasal corticosteroid mometasone furoate nasal spray (MFNS) for treatment of nasal polyposis was demonstrated in 2 large clinical trials.

Objective: To evaluate the onset of MFNS symptomatic effect, data from the 2 trials were pooled and analyzed to determine the first day subjects experienced significant symptom relief.

Methods: Subjects with nasal polyposis randomized to MFNS 200 microg twice daily or placebo scored symptoms on a 3-point scale (0 = none; 3 = severe) and measured peak nasal inspiratory flow immediately before the morning dose. Onset of symptomatic effect was defined as the first day a statistically significant (P < .05) lasting response was observed for MFNS compared with placebo.

Results: A total of 447 subjects with bilateral nasal polyps and clinically significant nasal congestion/obstruction were analyzed. Compared with placebo, MFNS 200 microg twice daily demonstrated statistically significant (P < .05) relief of anterior rhinorrhea by day 2 (-10.9% vs +5.7%), nasal congestion by day 3 (-15.1% vs -7.6%), postnasal drip by day 5 (+1.1% vs +4.6%), and sense of smell by day 13 (-9.6% vs -5.6%). Significant improvement in peak nasal inspiratory flow was seen by day 2 (increase of 6.22 L/min vs 1.48 L/min for placebo; P = .03).

Conclusion: Mometasone furoate nasal spray 200 microg twice daily rapidly improves the symptoms of nasal polyposis, leading to lasting relief of most major symptoms within 2 (24 hours after the first dose) to 5 days of initiating therapy.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal
  • Adolescent
  • Adult
  • Aged
  • Anti-Allergic Agents / administration & dosage*
  • Anti-Allergic Agents / therapeutic use
  • Asthma / complications
  • Asthma / drug therapy
  • Double-Blind Method
  • Female
  • Humans
  • Inspiratory Capacity / drug effects
  • Male
  • Middle Aged
  • Mometasone Furoate
  • Nasal Decongestants / administration & dosage
  • Nasal Decongestants / therapeutic use
  • Nasal Polyps / diagnosis
  • Nasal Polyps / drug therapy*
  • Nasal Polyps / etiology
  • Pregnadienediols / administration & dosage*
  • Pregnadienediols / therapeutic use
  • Rhinitis, Allergic, Perennial / complications
  • Rhinitis, Allergic, Perennial / drug therapy
  • Smell / drug effects

Substances

  • Anti-Allergic Agents
  • Nasal Decongestants
  • Pregnadienediols
  • Mometasone Furoate