Intranasal corticosteroids topical characteristics: side effects, formulation, and volume

Area of Science:

• Allergy and Immunology
• Pharmacology
• Otolaryngology

Background:

• Intranasal corticosteroids (INSs) are globally recommended as a first-line therapy for moderate to severe allergic rhinitis.
• Comparative studies generally show similar efficacy among different INS steroid moieties.
• Formulation variations may significantly influence patient treatment adherence.

Purpose of the Study:

• To review topical features of intranasal corticosteroids.
• To examine the impact of formulations, vehicles, and side effects on treatment adherence.
• To inform clinical practice regarding patient-specific INS selection.

Main Methods:

• Review of intranasal corticosteroid formulations.
• Analysis of vehicle types (aqueous vs. aerosol).
• Evaluation of common side effects, including epistaxis and nasal septal perforation.

Main Results:

• Topical side effects of INSs are generally minimal, with epistaxis being a notable exception.
• Significant variations exist in INS formulations, volumes, and delivery vehicles.
• These formulation differences can potentially affect patient adherence to treatment.

Conclusions:

• Physicians should recognize the diverse attributes of available INS products.
• Matching patient preferences with specific INS characteristics is crucial for enhancing adherence.
• Improved adherence through personalized selection can lead to better outcomes for allergic rhinitis patients.