Multicenter evaluation of triamcinolone acetonide nasal aerosol in the treatment of adult patients with seasonal allergic rhinitis.

Triamcinolone acetonide aerosol inhalation therapy is effective for the prophylactic treatment of asthma. Recently, the delivery system for this preparation has been modified for use in allergic rhinitis. A total of 180 adult patients with symptomatic seasonal allergic rhinitis participated in this double-blind, placebo-controlled, multicenter trial. Patients received either placebo or approximately 25 mg per actuation of triamcinolone acetonide aerosol per nostril, qid, for 4 weeks. Each patient kept a daily diary rating rhinitis symptoms. Both the patient and the physician also gave global evaluations of drug efficacy. Of 168 evaluable patients, significant reductions were seen at week 1, week 2, and in the overall study evaluation of ratings for intensity (P less than .001) and duration (P less than .05) of various rhinitis symptoms such as nasal stuffiness, discharge, and sneezing in the group given triamcinolone acetonide. Superiority to placebo group was evident as early as day 1 and maintained throughout the study. Both patients and physicians rated triamcinolone acetonide as significantly more effective than placebo for the duration of the study (P less than .001). There was a marked reduction in nasal smear eosinophils in the triamcinolone acetonide group. There was no difference between groups in safety evaluations including no evidence of suppression of the adrenal axis and no evidence of fungal infection. This study demonstrates that triamcinolone acetonide in a dose of 25 micrograms per nostril, qid, is effective, well tolerated, and safe in reducing symptoms in adult patients with seasonal allergic rhinitis.