Treatment of ragweed hay fever with an intranasal spray containing fluinsolide, a new synthetic corticosteroid.

Flunisolide, a new synthetic fluorinated corticosteroid, was administered as a nasal spray via a squeeze bottle to patients with ragweed hay fever for 4 wk during the hay fever season. Fifty-one patients, paired on the basis of similar skin sensitivity to intradermal ragweed (greater than or equal to 10-1 PNU/ml), were randomly assigned in a double-blind manner either an aerosol-containing flunisolide dissolved in vehicle (a mixture of polyethylene glycol and propylene glycol) or vehicle alone. Flunisolide was sprayed as a 0.025% solution two times in each nostril twice a day. Forty-eight patients completed the study. Three patients dropped out for reasons unrelated to flunisolide usage. On the basis of physician interviews and daily symptom dairy scores, patients receiving flunisolide showed significant improvement of hay fever symptoms when compared to their counterparts receiving vehicle. No systemic steroid side effects were observed. Morning plasma cortisol levels measured prio to and after 3 wk of flunisolide therapy showed no significant difference between the treatment groups. Adverse local effects were minor and were noted less frequently with flunisolide than with vehicle. Flunisolide's topical efficacy and lack of adrenal suppression provide distinct advantages over other steroid preparations available in the United States for treatment of seasonal allergic rhinitis.